Approximately 70% of the population carries the Helicobacter pylori (H. pylori) bacterium. While about half of these individuals won't experience symptoms like heartburn, pain above the stomach, bloating after eating, or constipation, others may face significant discomfort. For those without symptoms, a strong immune system is typically sufficient to manage the bacterium. However, for others, symptoms can initially appear as reactions to specific foods, especially acidic ones, and may worsen over time. Simply avoiding acidic foods may offer temporary relief, but in the long run, it won’t address the underlying issue. Additionally, taking acid-reducing medications may only assist the bacterium in embedding itself more deeply into the stomach lining.
There are several tests available to diagnose and treat H. pylori, and in this post, we'll explore the differences between them:
Diagnose H. Pylori
Breath Test:
This is the most commonly used test by healthcare providers. The test involves ingesting a substance called urea, which is a waste product that the body uses to break down protein. If H. pylori is present, the urea is converted into carbon dioxide, which can be detected in your breath within 10 minutes. Considerations: Certain medications, including gastrointestinal bleeding, can result in a false negative. Additionally, this is an indirect test and does not measure the bacterium itself.
Endoscopy and Biopsy:
This invasive procedure involves inserting a long, flexible tube with a camera through the throat and esophagus into the stomach and upper intestine. Sometimes, tissue samples are taken for a biopsy. Considerations: Detecting H. pylori depends significantly on the number and location of the samples taken. The bacterium tends to settle unevenly in the stomach, so it can easily be missed if the samples aren’t taken from the right area.
Blood Test:
This test measures antibodies to H. pylori in the blood. Antibodies are proteins produced by the body’s immune system when it detects harmful substances like bacteria. Considerations: This test can only show if you have antibodies, not if you have an active infection. It also cannot be used to check if the infection has cleared after treatment.
Stool Antigen Test:
A common test for H. pylori, this test looks for antigens to H. pylori in the stool. Considerations: This test often leads to false negatives because most antigen tests cannot detect H. pylori in the stool unless there are at least 5,000–10,000 cells per gram of stool.
qPCR Stool Test:
PCR stands for Polymerase Chain Reaction. This test not only detects H. pylori in the stool but also identifies mutations that may be resistant to the antibiotics used to treat H. pylori. Considerations: This test is the most sensitive for detecting H. pylori. It can identify the bacterium if the lab finds 100+ cells per gram of stool, compared to antigen tests that require at least 5,000. This is my preferred testing method, and I use the GI-MAP test.
In Summary, here’s how these tests rank from most to least effective:
1. qPCR Stool Test
2. Breath Test
3. Stool Antigen Test
4. Endoscopy
5. Blood Test
Addressing H. Pylori
Treating H. pylori can involve both traditional and functional medicine approaches. Here’s a look at options from both perspectives:
Traditional Medicine Treatments
A combination of two antibiotics (usually clarithromycin and amoxicillin or metronidazole) and a proton pump inhibitor (PPI) to reduce stomach acid for a period of 7-15 days is typically recommended by traditional practitioners and doctors.
While using antibiotics to treat H. pylori can be effective, there are several downsides to consider:
Antibiotic Resistance:
H. pylori is known to develop resistance to commonly used antibiotics like clarithromycin and metronidazole. If the bacterium becomes resistant, the treatment may fail, leading to persistent infection and the need for stronger or alternative antibiotics. Repeated use of antibiotics increases the risk of resistance, which can limit treatment options for future infections, not just for H. pylori but for other bacterial infections as well.
Gut Microbiome Disruption:
Antibiotics do not discriminate between harmful and beneficial bacteria, so they can disrupt the balance of the gut microbiome. This disruption can lead to side effects such as diarrhea, bloating, and an increased risk of opportunistic infections like *Clostridium difficile* (C. diff). A disrupted microbiome can have long-term consequences for digestive health, immune function, and even mental health, as the gut-brain axis plays a crucial role in overall well-being.
Side Effects:
Antibiotics can cause side effects such as nausea, vomiting, diarrhea, abdominal pain, and a metallic taste in the mouth. These side effects can be uncomfortable and may lead to poor adherence to the treatment regimen.
Some individuals may experience allergic reactions to certain antibiotics, ranging from mild rashes to severe anaphylaxis.
Incomplete Eradication:
Even with antibiotic treatment, there is a risk that the infection may not be fully eradicated, particularly if the bacteria are in a dormant or less active state. This can lead to a recurrence of symptoms and the need for additional treatment.
Impact on Stomach Acid:
Antibiotic treatment for H. pylori is often paired with proton pump inhibitors (PPIs) to reduce stomach acid. Long-term use of PPIs can have its own downsides, such as increased risk of nutrient deficiencies (e.g., vitamin B12, magnesium), bone fractures, and changes in gut microbiota.
After stopping PPIs, some people may experience a rebound increase in stomach acid production, which can lead to worsening of symptoms like heartburn and indigestion.
Risk of Recurrence:
Even after successful treatment, it’s possible to become reinfected with H. pylori, particularly if exposure risks (like contaminated food or water) are not addressed. This can lead to a cycle of repeated antibiotic use.
Impact on Overall Health:
Frequent use of antibiotics can weaken the body’s natural immune response, making it more difficult to fight off infections in the future.
Disruption of the gut microbiome due to antibiotics has been linked to an increased risk of developing other health conditions, such as autoimmune diseases, obesity, and mood disorders.
Functional Medicine Treatments
The functional medicine approach to treating H. pylori focuses on addressing the root cause of the infection while supporting the body’s natural healing processes. Unlike conventional treatments that rely primarily on antibiotics, functional medicine emphasizes a holistic strategy—using diet, lifestyle changes, and targeted supplements to restore balance to the gut microbiome, reduce inflammation, and strengthen the immune system. This integrative approach not only aims to eradicate the bacterium but also to promote long-term digestive health and overall well-being.
Dietary Changes:
Elimination of Trigger Foods: Reducing or avoiding foods that can irritate the stomach lining, such as spicy, acidic, or fried foods.
Anti-Inflammatory Diet: Emphasizing whole foods, fruits, vegetables, and healthy fats that reduce inflammation in the body.
Probiotic-Rich Foods:Including fermented foods like yogurt, kefir, sauerkraut, and kimchi to support a healthy gut microbiome.
Probiotics:
Probiotic supplements, especially strains like *Lactobacillus* and *Bifidobacterium*, can help restore the balance of good bacteria in the gut, reduce H. pylori colonization, and mitigate side effects of antibiotic treatment.
Herbal Supplements:
Mastic Gum: Known for its antibacterial properties, mastic gum can help reduce H. pylori levels.
DGL (Deglycyrrhizinated Licorice): This form of licorice root can soothe the stomach lining and has mild antibacterial effects.
Berberine: An herbal compound with antimicrobial properties that can help combat H. pylori.
Oil of Oregano: Has natural antibacterial and antifungal properties that may help reduce H. pylori.
Nutritional Support:
Vitamin C: Known for its immune-boosting properties, Vitamin C can help the body combat H. pylori infection.
Zinc-Carnosine: A combination that has been shown to protect the stomach lining and support healing from H. pylori-related damage.
Gut-Healing Protocols:
Using supplements like L-glutamine, aloe vera, and bone broth to support the healing of the stomach lining and reduce inflammation.
If you're looking to get to the root of your digestive issues and determine if H. pylori might be the problem, reach out to me, and we can schedule a consultation.
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