As I have discussed in many other posts, SIBO is a secondary symptom of a bigger problem. You have to dig deeper to find your root causal issues to make lasting progress. One of the root causal issues that I see when working with clients is h. pylori.
H. pylori is a gram negative gut bacteria that is known for its role in creating stomach ulcers. H. pylori has a unique ability to survive and colonize the stomach. The low pH due to the acidity of the stomach usually kills most gut bugs but not h. pylori.
A pathogenic overgrowth of h. pylori can lead to SIBO by disrupting digestion in the stomach. When digestion is disrupted in the stomach, it sets you up for poor digestion down stream in the small intestines. Clearing h. pylori can be an important step in keeping SIBO away for good.
Consider this post a 411 on h. pylori. Let’s dive into it!
Why does h. pylori lead to SIBO?
As I mentioned above, h. pylori can lead to SIBO by lowering stomach acid levels. While conventional medicine wants to blame all heartburn on too much stomach acid, low stomach acid can create huge problems.
Your stomach was meant to be acidic! This acidity helps to stimulate digestion down stream. How does h. pylori deplete stomach acid levels? There are two primary ways it lowers stomach acid:
First, h. pylori can produce an enzyme called urease. This enzyme neutralizes stomach acid. H. pylori depends on this enzyme to lower the stomach acid levels so that it can survive.
Second, certain strains of h. pylori produce virulence factors that damage the stomach lining leading to gastritis and ulcers. Virulence factors are proteins that a bacteria can produce that help the it colonize, cause disease and evade your immune defense.
Not all h. pylori produce virulence factors. But, when your h. pylori strains are producing virulence factors, the damage to the stomach lining will further reduce stomach acid levels.
Continued digestion and absorption is highly dependent on the acidity of the chyme (food blob) as it exits the stomach. The chyme optimally has a pH of 2 as it exits the stomach into the duodenum of the small intestine.
The high acidity triggers the hormone CCK to be released. CCK is responsible for stimulating the release of bile and digestive enzymes. If stomach acid is low from h. pylori infection in the stomach, then CCK levels will decline leading to less bile and digestive enzymes being released.
With less food being digested, your small intestines becomes an environment ripe for an overgrowth. That is why it is important to treat damaging h. pylori infections.
H. Pylori is not always bad
According to Dr. Martin Blaser, the director of the Human Microbiome Project, there is a popular saying in the gastroenterology world: “the only good h. pylori, is a dead h. pylori”. But, Blaser disputes this belief in his book Missing Microbes: How the Overuse of Antibiotics is Fueling our Modern Plagues.
Dr. Blaser claims that h. pylori has been a part of the stomach ecosystem forever. He argues that there is evidence to support that h. pylori has can have benefits like protecting us from GERD and even asthma.
The big takeaway I had by reading through Dr. Blaser’s arguments is that there are a lot of strains of h. pylori and not all are harmful (and as mentioned above some can be helpful). You can think of this like E. coli. We all have E. coli in our guts amd most are harmless. But, there are a few strains that can cause disease. It is similar with h. pylori.
If you test positive for virulence factors, clearing h. pylori becomes necessary. If my clients has no virulence factors but still have h. pylori show up on their stool test, I usually like to analyze other digestive markers and also symptoms to determine if clearing the h. pylori is necessary.
How is h. pylori diagnosed?
I look for h. pylori in stool tests. I like that the GI MAP because it has virulence factors that can help determine if the h. pylori is disease promoting.
Your doctor can also do stool tests through more conventional labs. Gastro docs also usually culture the stomach looking for h. pylori when you have an endoscopy done. There is also a breath test are used as well.
Understanding the symptoms of h. pylori can help you determine if testing is needed. Symptoms of h. pylori infection include:
- Feeling burning or gnawing pain in stomach when you have not eaten in awhile
- Bad breath
- Indigestion 15-30 minutes after a meal
H. Pylori Solutions
Conventional treatments for h. pylori are harsh. Usually docs prescribe triple or quadruple antibiotic therapy to kill h. pylori followed by PPIs to help heal ulcers or inflammation. There is a lot of potential for collateral damage with these strategies and I believe most cases of h. pylori can improve with other gentler strategies.
For h. pylori, I would definitely work closely with a practitioner to determine what solutions make the most since for your particular case. Here are some of the strategies that I use often:
Zinc Carnosine and/or DGL for lining support. If h. pylori is thinning the gastric mucosa and inflaming the stomach lining then DGL and zinc carnosine have been shown to increase mucosal defenses against h. pylori.
SBI (serum bovine immunoglobulins) since it has been shown to bind to h. pylori. Binding this microbe will neutralize and eliminate it from the body.
Mastic Gum can be used as an antimicrobial agent to kill h. pylori. Instead of devastating antibiotics, mastic gum can clear out h. pylori without obliterating the delicate gut balance downstream like antibiotics do. Discuss dosage with a practitioner, but studies typically use 1 gram.
S. boulardii has been shown to reduce the colonization of h. pylori. I usually use this in combination with other strategies, but it can help balance out the gut and increase immune activity against h. pylori.
Bacillus subtilis to help clear and balance out the stomach. This strain can be used in combination with S. boulardi and other bacillus strains.
Green tea has been shown to inhibit h. pylori. I really like PIQUE tea brand since it is much higher in polyphenol content than other brands of tea.
Grape seed extract (not to be confused as grapefruit seed extract) to help inhibit h. pylori. Grapeseed extract similar to green tea has high levels of powerful polyphenols that have been shown to inhibit h. pylori growth
H. pylori can lower stomach acid leading to a SIBO friendly environment. Clearing h .pylori can be a crucial step to finding long term relief from SIBO.