Helicobacter pylori (HP or H. pylori) is a stomach bug that infects half the world’s population. Often, we acquire it when we’re children and it lives within us for most of our lives. If it sticks around long enough it can cause ulcers in your stomach and intestines, and can further progress to stomach cancer. It’s even associated with skin conditions and bleeding disorders!
In today’s article we’ll explore just how big of a problem this infection is. We’ll look at some of the symptoms and associations with other conditions. I’ll also discuss testing methods and some of the pitfalls and risks of conventional treatments. Finally, we’ll look at some safe and effective natural treatments for H. pylori. They not only work well alongside medications but actually enhance them!
Why Is It Important To Treat?
Well, first, it causes stomach cancer. So that’s a big reason!
The infection also causes local inflammation and ulceration of your stomach and small intestine. It can alter the stomach’s ability to produce stomach acid (increase or decrease). It results in less bacterial diversity throughout the entire gut and that’s not a good thing!
Not all H. pylori strains will do these things. There are genes that code for how destructive or cancerous the H. pylori strains will be. These are known as virulence factors.
The two most well known virulence factors are the cagA and VacA genes. They are responsible for the cancer-causing and ulcer- forming effects of chronic H. pylori infection.
Survival of the fittest
H. pylori is so successful in infecting the stomach because of its survival strategy. The bug produces something called urease. This is an enzyme that breaks down a compound known as urea. When urea is broken down it forms ammonia and carbon dioxide. Because these compounds help buffer acid, it helps the bacteria survive in the acidic stomach. Also, H. pylori has has these little hooks that can attach to the stomach lining, creating the setting for chronic inflammation and tissue damage.
So how do you know if you’re infected?
H. pylori Symptoms
- Bad breath – ammonia and nitrogen-forming compounds formed during the infection can cause this.
- Stomach pain (dyspepsia)
- Nausea
- Belching
- Bloating
- Thick yellow coating on the tongue
- Heartburn
H. pylori infection can extend its reach beyond the digestive tract as well!
Non-Digestive Symptoms
Immune thrombocytopenia or ITP – This is an autoimmune bleeding disorder that affects your blood-clotting ability. It specifically attacks your bodies platelets depleting them. This leads to excessive bleeding and can be quite dangerous for obvious reasons. There’s a well established connection between H. pylori infection and ITP.
It’s really fascinating to look at why this association exists. One theory of how this might happen is through a process called antigen mimicry.
An antigen is a protein “signature” that can be recognized by immune cells. They exist on bacteria, other immune cells, and even foods. H. pylori produces antigens and our immune system can recognize them. What happens next is the immune system builds antibodies to these antigens so that we can either tolerate these bugs or help us kill them. Our platelets contain similar antigens. In fact, they look so similar that our immune system is tricked into thinking its the H. pylori antigen when it’s not. This causes our own immune cells to attack our platelets. Death by friendly fire!
What’s more interesting is what happens when we treat H. pylori in individuals with ITP. Not surprisingly, their platelets increase. They stop bleeding as much. Their condition becomes much more manageable – it might even reverse completely!
H. pylori and the Skin
Next, let’s explore the relationship between HP and a common skin condition called Rosacea. This is an inflammatory skin condition that causes redness, pimples and visible blood vessels to appear. It most commonly affects the cheeks, nose and eyes. Like acne, rosacea can cause significant social stigmatization and worsen quality of life. It increases the risk of depression and mental health issues. Therefore, figuring out why this happens is important!
While researchers don’t fully agree on whether a relationship exists, most studies suggest one does. Further, treatment of HP can improve the symptoms of rosacea. In some studies even more so than medications designed to treat rosacea!
Small intestinal bacterial overgrowth (SIBO) may play a role in rosacea as well. Not sure what SIBO is or if you might have it? Read this article
H. pylori Testing
There are several testing methods to determine whether or not you have this infection. Each of them have their strengths and weaknesses so I’ll review them briefly here:
Biopsy
This is the most reliable way to test for H. pylori in your stomach. During an upper endoscopy your doctor will stick a camera down your throat and will take samples from different parts of your stomach. They will then apply a special stain to see if you have the infection. This is considered the gold standard for diagnosis. As you can imagine, this isn’t the most pleasant procedure and doesn’t come without its risks. It’s also not the preferred testing method for those under the age of 50 and with those without alarm features.
The remaining 4 methods of testing are much less invasive:
Urea Breath Test
Believe it or not breath testing is the most accurate non-invasive way to test for H. pylori infection. The test involves consuming a carbon-traced solution containing urea. If HP is present in the stomach it will then convert this into carbon dioxide. We can then measure this in the breath. The downside of this test is that other bacteria can produce urease, the enzyme that breaks down urea. Although not often, this test can produce false positives.
Stool Antigen
We talked about antigens above. These one can be measured in the stool. If you’re cool with stool tests then this is a good option. If the thought of collecting a stool sample mortifies you then a breath test would be a better option.
Blood Antibodies
This will determine if you have previously been infected with H. pylori. The test can’t differentiate between a past and present infection. For this reason it is the least accurate test. It will not tell you whether treatment was successful either. As antibodies can still be present up to 6 months after eradication. On the other hand, if you have never been treated for H. pylori then the test is valid for detecting an infection.
DNA Stool test
This is a newer test option that looks for the presence of H. pylori DNA in the stool. We run this test as part of a larger comprehensive stool analysis (CSA). A CSA looks at many aspects of intestinal health and is one of the labs I use in my practice. One of the benefits of DNA testing is the ability to detect which antibiotics the bacteria are resistant too. This helps tailor your treatment for the best outcomes. The other benefit is that these tests can detect virulence factors like cagA and vacA. This helps determine your pre-treatment risk for developing things like ulcers and stomach cancer.
Treatments For H. pylori
Conventional treatments often include a combination of antibiotics and strong antacids known as proton-pump inhibitors (PPIs). While these treatments often work, they frequently come with a price.
The most common side effect: antibiotic-associated diarrhea.
It might start with mild stomach cramps, then progress to loose stools or even watery diarrhea. In fact, as many as 40% will experience this side effect!
And if they don’t work?
Here’s a familiar example: you’ve been on amoxicillin several times throughout your childhood. Because you’ve been exposed to the same antibiotics, H. pylori learns to adapt and develops resistance to them. Antibiotic treatment fails and you develop diarrhea. Not to mention, your original symptoms persist and you are once more thrust into treatment. Hopefully this time, a different regimen of drugs are used. Although some are just put on the same cocktail only for a longer time, which, is often as unsuccessful as the first attempt.
H. pylori Natural Treatments
There are many natural treatments for H. pylori. Thanks to increasing research interest in these areas we have safe and effective treatments for H. pylori
Probiotics
Probiotics are on the top of my list. They have the best evidence for reducing antibiotic associated diarrhea. As an added bonus, they also significantly improve eradication rates and reduce antibiotic resistance. Hard to argue with those outcomes!
I believe probiotics should always be recommended alongside antibiotics. However, not all probiotic strains are created equal. Therefore, It’s important to choose the strains that actually do the things I just mentioned.
Read my previous article on probiotics to see which strains help reduce antibiotic-associated diarrhea.
Broccoli Sprouts
The sulfur-rich compounds in broccoli sprouts can create a compound known as sulphoraphane. This increases your bodies’ antioxidant production. This is important because chronic H. pylori infection causes oxidative damage of the stomach. This process is akin to your insides rusting leading to inflammation, ulceration and eventually cancer. Sulforaphane also inactivates the urease enzyme. This takes away the ability of H. pylori to survive in the acidic environment of the stomach.
How much do you need? Not much, In fact, studies show that the equivalent of half a cup of broccoli sprouts daily over 8 weeks improved gastritis and reduced H. pylori colonization. Food is powerful medicine!
Vitamins & Minerals
Researchers have looked at several vitamins and minerals like vitamin C, E and zinc to see if they can be helpful for reducing the burden of H. pylori. The jury is still out on these as the results have been mixed. However, a new 7-year study showed that vitamin supplementation (C, E, & selenium) with and without medical H. pylori treatment significantly reduced the rates of death from stomach cancer years later!
What’s important about this study is that it isn’t an observational study, which is a type of study that basically observes someones behaviours over time. The researchers don’t influence the participants but instead look for any trends in health and disease associated with these behaviours. On the contrary, this was a randomized control trial where participants are randomly placed into a treatment or placebo group. They then compare the rates of death and cancer incidence in both groups. This is a much better way of determining if natural treatments for H. pylori can be helpful.
Polyphenols
Polyphenols are plant compounds with various health benefits. They make up the pigments in fruits and vegetables. Cranberries, grapes, green tea, even dark chocolate are packed with these antioxidant, gut-feeding prebiotics. Both cranberry extracts and green tea show promise as effective natural treatments for H. pylori.
I tell patients to “eat the colors of the rainbow” to make sure they consume many different types of polyphenols. This helps not only with treatment and prevention of H. pylori infection but is also helpful in maintaining optimal health overall.
In Summary
H. pylori infection is very common and often under-looked, especially when you don’t have digestive symptoms. It can cause stomach cancer, chronic inflammation of the stomach and ulcers. Further, it can play a role in both the development and treatment of rosacea and immune thrombocytopenia. Natural treatments can increase the eradication of H. pylori and dramatically reduce the side effects associated with drug treatments. A win-win scenario!
If you or a loved one has gone through several rounds of unsuccessful treatment, don’t give up. If you have just been diagnosed, then you should consult with a naturopathic doctor who can help you increase treatment success while reducing side effects.
References:
Kuwana, Masataka. “Helicobacter pylori-associated immune thrombocytopenia: clinical features and pathogenic mechanisms.” World Journal of Gastroenterology: WJG 20.3 (2014): 714.
Jørgensen, A‐HR, et al. “Rosacea is associated with Helicobacter pylori: a systematic review and meta‐analysis.” Journal of the European Academy of Dermatology and Venereology 31.12 (2017): 2010-2015.
Wong, Frank, Erin Rayner-Hartley, and Michael F. Byrne. “Extraintestinal manifestations of Helicobacter pylori: a concise review.” World journal of gastroenterology: WJG 20.34 (2014): 11950.
Yanaka, Akinori, et al. “Dietary sulforaphane-rich broccoli sprouts reduce colonization and attenuate gastritis in Helicobacter pylori–infected mice and humans.” Cancer Prevention Research 2.4 (2009): 353-360.
Hussain, Azhar, et al. “Vitamin C: A Preventative, Therapeutic Agent Against Helicobacter pylori.” Cureus 10.7 (2018).
Li, Wen-Qing, et al. “Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial.” bmj 366 (2019): l5016.