Welcome to the Gut Honest Truth blog where a Certified Functional Medicine Practitioner gives you digestible information to tackle your chronic health concerns.
That’s me, Katie Morra;
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On to the post...
What is Helicobacter pylori aka H. pylori?
H. pylori is the most common gut pathogen and infection worldwide. Over 50% of the population carries this bacteria. We have actually been co-evolving with H. pylori for over 50,000 years.
It is a gram negative, double cell membrane, helical rod with sheathed flagella bacteria. You may be saying, what do I need to know that. Honestly, you don't but the reason I think it is important to inform you about it is that the actual shape of this bacteria makes it more resistant to treatment. It actually can morph into another form called the coccoid form as well, which is essentially a ball shaped form that is even more tricky to test and treat. The shape and morphology itself is just one of the many reasons that it can be so tricky to treat and fully eradicate.
You may also be wondering, how do I get H. pylori? The list is endless! This bacteria can actually be transmitted in the following ways:
Gastric-oral
Oral-oral
Vaginal-oral
Fecal-oral
Water-oral
Zoonotic
Which means it is often referred to as a household condition. Let's say your spouse is positive for H. pylori, due to all of the ways we share bodily fluids and germs listed above) there is a 68% chance that YOU also have H. pylori. And what about the children? There is up to a 40% chance that the children are also positive if one of the parents is a carrier.
What are the symptoms of H pylori?
Burning/ aching in the abdominal region, especially on an empty stomach
Nausea
Loss of appetite
Burping
Acid reflux/GERD
Halitosis
Belching
IBS symptoms
Fatigue
Sleep problems
Nutrient deficiencies
Histamine and skin issues
Mood changes
Blood sugar dysregulation
Infertility issues
Autoimmune conditions
Stomach ulcers
Gastritis
Stomach cancer (~2% of population)
How is H. pylori tested?
Urea Breath Test:
A good test but meds and GI bleeds can lead to a false negative. Indirect test, measures the byproduct of the bacteria in high levels rather than the bacteria itself.
Biopsy:
Requires that the biopsy be taken from a site that has H. pylori on the tissue. H pylori does not evenly colonize in the stomach, leading to a false negative.
Blood:
Depends on the lab drawn (IgG, IgA, IgM) - each test is interpreted differently. Example- IgG could cause false negatives since some people only produce IgA levels.
Stool Antigen:
A good test for H. pylori, but not nearly as sensitive as qPCR. Detects H. pylori when at least 5,000 cells per gram of stool, which is a pretty high level.
qPCR: Highly sensitive and specific for H. pylori. Reports the value if 100+ cells of H. pylori per gram of stool. PCR testing for H pylori- sensitivity nearing 100% and specificity of 100% can be obtained.
Is H. pylori always an issue?
It may be commensal
When your immune system and gut microbiome are robust and thriving and if you are not struggling with the symptoms listed above, it is often consider commensal and you can live a healthy, happy life as long as it is living in harmony with the rest of your gut bugs.
Consider age
Research shows that H pylori may be beneficial for children. You need to also take into consideration health concerns and symptoms of your child and whether working on minimizing the bacteria level to encourage toleration of your immune system is important.
May be protective
Possibly protective against allergies, celiac disease and IBD.
How Do I Get Rid of H. pylori?
Medication Interventions
Triple or quadruple antibiotic therapy (including the use of a Proton Pump Inhibitor) is the most commonly prescribed treatment for H. pylori. However, a majority of the most commonly prescribed antibiotics (Clarithromycin, Metronidazole and Fluroquinolones) have up to 30% of the bacteria being antibiotic resistant to those therapies. That is a pretty high percent risk when we are already taking the risk on of greatly imbalancing the gut microbiome, immune function in the gut and risks for conditions like c. difficile. That doesn't mean we shouldn't prescribe or take antibiotics, especially if we have been diagnosed with stomach ulcerations or extreme weight loss and symptoms. It's just some facts to know when are considering the best initial starting place for our patients. We can also test antibiotic resistant genes PRIOR to taking them, which is wonderful news. In our clinic, we use the GI Map to both test for the bacteria, the virulence factors (increases disease potential) as well as antibiotic resistant genes.
Natural Interventions
There are some amazing botanicals and herbal products on the market showing great efficacy in treatment of H. pylori. Let me share an interesting study with you: Successful Eradication of Helicobacter pylori With Over-the-counter Products
In this study 1209 patients' stool samples were analyzed using DNA probe polymerase chain reactions (PCR) to detect H. pylori. Total of 314 samples (26%) were found to be positive for H. pylori. Of the 314, 39 patients agreed to move forward with the trial of nonprescription therapies for 2 weeks.
"Post-treatment 74.3% had converted to negative, suggesting complete biological eradication of H pylori. Four of the participants who failed to respond to this treatment were subsequently prescribed standard antibiotic therapy (lansoprazole, amoxicillin, clarithromycin or Prevpac) and retested. Two of these 4 converted to H pylori‒negative, while 2 remained H pylori‒positive as tested by PCR, suggesting that some H pylori infections were refractory to both our nonprescription protocol as well as to Prevpac. "
This research article only mentions 5 of at least 20 amazing botanicals and herbals on the market that have various modes of action in supporting the clearance of H. pylori. I highly recommend working with a practitioner that specializes in gut health to adequately test for and support your gut healing journey. You can find a practitioner by you by heading to the Institute for Functional Medicine website or get started today with a member of the Gut Honest Truth team.
Final considerations and thoughts
Don't assume you only have H. pylori and nothing else within the gut is imbalanced. I recommend completely a full GI Map test to check what else may be going on and ensure your immune system doesn't need a little support prior to a kill off protocol.
Highly recommend testing the whole household, regardless of symptoms, or do not be surprised when you have a tough time clearing it or it comes back fairly soon after you treat.
If you are about to be treated for H. pylori do not forget to properly clean your dental appliances and replace your toothbrush.
Talk to your provider about some dietary approaches to help eradicate H. pylori growth.
If you and your practitioner decide the ultimate goal for you is total eradication, do not skimp out on the repeat testing after treatment, even if you are feeling better. You may have lowered the number but it may not be fully eradicated.
I really do recommend working with a knowledgeable practitioner versus trying to treat yourself. Often more negatives come with that than good, including a waste of your resources, time and energy.