What Causes H. Pylori Infection…The Most Insidious Infection Around?
By Dr. Justin Marchegiani
What causes H. pylori infection? Did you know that over 50% of the population has an H. pylori infection (1)? Dr. Marshall, the scientist who discovered H. pylori, won the Nobel Prize in medicine in 2005 for his discovery. His initial research was done on himself, as he infected himself to prove the bacteria’s causal connection with gastritis (inflammation of the stomach).
H. pylori is an opportunistic infection that spreads more rapidly in people that have a compromised immune system. This is why there are higher rates of all parasite infections in Third World countries. In the United States, we are seeing an increase in chronic stress and poor eating habits, which compromises our immune function and makes us open for an attack.
How Do You Get an H. pylori Infection?
H. pylori, unlike other parasitic infections, can be spread very easily via saliva and doesn’t require sexual intimacy per se. This is why it’s very common to see an entire family test positive for an H. pylori infection. Things like sharing a drink or silverware can be enough to spread the infection in a compromised individual.
What does H. pylori do to our body?
One of the biggest problems with H. pylori is its production of a specific enzyme called urease, which essentially neutralizes hydrochloric acid due to its increased production of ammonia. Hydrochloric acid is needed to help digest protein, ionize minerals, and create an acidic environment in the guts to stimulate bile release from the gallbladder, which aids in fat digestion in the small intestine.
If we can’t ionize our minerals properly, this will lead to a whole host of issues, including osteoporosis, immune problems, thyroid problems, and anemia. Lack of hydrochloric acid will also lead to indigestion, malabsorption, gas, bloating, and a catabolic physiology (your body breaking down faster than it can build up).
A large percentage of H. pylori infected patients will not present with any symptoms, so it’s possible you could be feeling great and still have an infection. This is also why my recommendation for anyone with an H. pylori infection is to supplement with hydrochloric acid and enzymes to ensure optimal digestion, even if no digestive symptoms are present.
It’s important to note that the enzymes and hydrochloric acid by themselves will not be enough to eradicate the infection. A proper assessment should be made by your functional-medicine doctor regarding your primary physical, chemical, and emotional stressors to ensure long-term eradication of the infection.
H. pylori also irritates the stomach lining, hence its connections with gastric ulcers. This essentially creates silent inflammation, and now your adrenal glands have to come to the rescue to put out the smoldering fire in your gut. Your body uses cortisol from the adrenal glands to help put out the fire. But as your adrenals become more fatigued, cortisol will lose its capability of keeping the fire under control. This is the point where you will start to see the exacerbation of your symptoms. Many people can have this infection for a long period of time and not necessarily have any symptoms until their adrenals drop into stage III adrenal fatigue.
What Makes H. pylori Different?
H. pylori is a gram-negative bacteria. What this means is that H. pylori has two cell walls while most bacteria (gram positive) only have one cell wall (see picture below). When there are two cell walls, it makes it harder for antimicrobial medicines and herbs to eradicate the infection. This is analogous to a castle with stone walls for protection also being surrounded by a moat, which makes it more difficult for any intruders to invade.
Efflux Pumps and Antibiotics
In between the first and second cell wall, there is something known as efflux pumps. These pumps have the ability to disperse the antibiotic medicines that were given to the patient back outside into the gastrointestinal tract. These efflux pumps are believed to significantly contribute to antibiotic resistance, which is so prolific today (2).
When the antibiotics are pumped back into the gastrointestinal tract, patients can experience more die-off reactions. These reactions can include fatigue, nausea, bloating, flu-like symptoms, and diarrhea. H. pylori has obviously adapted in a way that has made it more resistant to antibiotics. This is one of the main reasons why I’m such a fan of herbal medicines, as they can be used for longer periods of time and don’t seem to have the same side effects as antibiotics.
The other major issue with gram-negative bacteria is that the outside of the bacteria is toxic. This toxin is known as lipopolysaccharide (LPS), or endotoxin, which is actually toxic to the liver. The more H. pylori becomes eradicated from your body, the more your detoxification pathways become stressed from the toxic debris! This is why I find removing the infection over a longer period of time and using additional herbs to help with drainage and detoxification can be beneficial in reducing those die-off reactions.
The most common or conventional symptoms of H. pylori infection:
- Abdominal pain
- Bloating and fullness
- Dyspepsia or indigestion
- Feeling very hungry one to three hours after eating
- Mild nausea (may be relieved by vomiting)
Less common symptoms of H. pylori infection:
- Neurological pain
- Anemia (B12 or iron)
- Leaky gut (gastrointestinal permeability)
- Depression and anxiety: All of the neurotransmitters in our body are made from proteins and amino acids.
- Constipation and diarrhea: Inflammation can disrupt motility in the GI tract.
- Crohn’s, ulcerative colitis, or any other digestive disorder
- Explainable weight gain.
- Fatigue or thyroid disorder: H. pylori is linked to autoimmune thyroid disease (6).
- Blood tests: These tests are indirect and assess the specific immune responses to the H. pylori infection. The immune responses that are measured are H. pylori and IgA, IgG, and IgM antibodies. If you test positive for IgA or IgM, you can be confident that you have an active H. pylori infection. Research has shown that test results in patients that are positive for IgG antibodies tend to drop within six months of H. pylori removal (5).
- H. pylori breath test: This test measures increased levels of CO2, which is the by-product of urease and nitrogen. H. pylori breath tests tend to only show acute infections.
- Stool test: H. pylori stool tests are the gold standard and are the only tests that look for the actual particles of the H. pylori bacteria.
- Endoscopy: This test is the most invasive and tends to be the least reliable, especially if you have no overt symptoms. This test can be good at assessing cancer as well as damage to the stomach, duodenum, and esophagus. For most individuals this test is unnecessary and is only recommended for high-risk patients.
Conventional Treatment Options and the Prevpac
Patients who have H. pylori and also have an ulcer are most likely to benefit from being treated. The treatment does not work in all patients.
Treatment must be taken for 10 to 14 days. Medications may include the Prevpac, which is a combination of three antibiotics.
- Clarithromycin (Biaxin)
- Amoxicillin, tetracycline, or metronidazole (Flagyl)
- Proton-pump inhibitors, such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium)
- Optional: Bismuth subsalicylate (Pepto-Bismol), in some cases
Natural Treatment Options
- Mastica (3)
- Burberines (4)
- Oil of oregano
- Olive leaf
- Black walnut hulls
- Probiotics (4)
- Vitamin C (4)
It’s very important the right combination of herbs as well as the right dosage of herbs are used. I strongly recommend a customized program by a functional-medicine doctor specific to your needs. This will give you the best chance of removing the infection the first time without terrible die-off reactions. If you have any of the symptoms mentioned in this article, click here to schedule a complimentary consult.
5 Signs You May Have Low Stomach Acid
By Dr. Justin Marchegiani
Do you suffer from any of the following?
- Indigestion: Food doesn’t sit well after you eat.
- Heartburn: You have GERD (gastro esophageal reflux disorder).
- Constipation: You don’t pass at least 12 inches of stool per day.
- Gas: This is primarily in the form of belching or flatulence.
- Nutrient Deficiency: You have a past history of anemia or are low in certain micronutrients.
What is stomach acid, and why is it important?
Your body produces hydrochloric acid (HCl) for these primary purposes:
- It activates pepsin, a specific proteolytic enzyme found in the stomach.
- Pepsin’s primary job is to break down protein.
- It provides an acidic pH in the stomach. This helps to decrease the chance of outside infections from proliferating like parasites, bacteria, and fungus.
- It produces acidic chyme (the mixture of food in the stomach). When chyme is released from the stomach into the small intestine, the acidity stimulates the gallbladder to release bile and the pancreas to produce enzymes (lipase and chymotrypsin, to name a few).
- It ionizes minerals so they can be broken down and absorbed by the body.
- It stimulates gastrin, which helps protect the stomach and improve digestion.
Digestion and HCl
HCl is really, really important to start the domino cascade of healthy digestion. If that first digestive domino isn’t knocked over, it’s safe to say you are at a higher risk of digestive symptoms.
As mentioned above, HCl activates enzymes in the stomach, small intestine, and pancreas to start breaking down carbohydrate, protein, and fat. If HCl secretion isn’t initiated in the stomach, you will start to see a putrification, or rotting, of the proteins; fermentation of carbohydrates; and a rancidification of fats (1).
Indigestion Creates Gas and Burning!
When the enzymes that are needed to break down these foods aren’t present, we start to see malabsorptions occur. These malabsorptions cause an increased intra-abdominal pressure, which can cause a weakening of the esophageal sphincter. When the esophageal sphincter loosens, this allows the organic acids from the rotting foods to rise up (reflux or GERD) and burn the esophageal tissue (2). Remember, esophageal tissue doesn’t have the protection (mucus) from an acidic environment like the stomach does.
Essentially, low stomach acid provides the environment for bacterial overgrowth in the stomach/small intestine to occur, which then creates malabsorption. You are now set up for a vicious cycle of poor digestion that almost never improves on its own unless the underlying cause is addressed (3) .
When food isn’t broken down completely, gas in the form of belching or flatulence is common. A dependency on pharmaceutical medications, like acid blockers, is now created that doesn’t address the underlying problem and only creates even bigger problems down the road, like B12 or iron anemias to name only a few (6). In my clinical experience, HCl helps reverse these conditions and improve digestion; therefore, decreasing stomach acid in the long run with drugs isn’t a good idea most of the time.
Stomach Acid Protects Your Stomach and Your Esophagus…Huh?
Yep, you heard it here first! Most people associate stomach acid as a problem. Yet stomach acid is needed for the stimulation of mucus from pyloric glands. This mucus acts as a shield against the stomach acid and protects the gastric mucosa.
The pyloric glands secrete mainly mucus for protection of the pyloric mucosa from the stomach acid. They also secrete the hormone gastrin.
~Guyton’s Text Book of Medical Physiology, 11th edition.
The more your digestive track loses the ability to break down protein, fats, and carbohydrates, the greater the chance for a bacterial overgrowth to occur. As the balance of bacteria becomes more dysbiotic (more bad bacteria in relation to good), this can weaken your esophageal sphincter as mentioned above and allow burning in the esophagus to occur.
Why Am I Constipated?
As the ratio of good bacteria and bad bacteria becomes flipped in favor of bad bacteria, all kinds of bad things occur. We start to see incomplete digestion, which has an effect on motility. The excess of bad microbes in the GI tract can produce chemicals that slow down peristalsis, or the wavelike contractions that move food through your intestines. If you have more bad bugs in your gut, your transit times get slower (4).
Most people I see with digestive symptoms have some sort of gut infection, either H. pylori or a myriad of other parasites that are notorious for causing these types of issues. Unless these infections are addressed, these digestive symptoms tend to linger. To learn more about how you can address these issues, click here!
Chronic constipation can also be connected to hypothyroidism as well. I strongly recommend ruling out any potential thyroid imbalances as well.
Stomach Acid Helps You Absorb Nutrients
HCl is needed to ionize minerals so they can be absorbed, assimilated, and utilized. There have been studies showing nutrient deficiencies in calcium, iron, and B12 when low stomach acid is present. Low stomach acid can even increase your chance of osteoporosis as well (5,6).
One of the most underutilized supplements is HCl, especially if you are already spending a good deal of money on organic food; you want to make sure you are absorbing and assimilating it properly. The old adage “you are what you eat” isn’t true. “You are what you eat, digest, assimilate, absorb, and utilize!”
If you have serious gastrointestinal irritation or a history of ulcers, you should not add any HCl into your supplement regimen without the guidance and support of a skilled functional medicine doctor. Some patients need more enzymes and gut healing herbs and nutrients before any HCl is introduced. This is on a case-by-case basis.
Guyton’s Text Book of Medical Physiology, 11th edition.