Healthy Decisions for the Love of Health

H. PYLORI and low Stomach Acid:  Nutritional Causes, Prevention and Therapies  by  Ronald Roth

While "stress" was a popular basis for stomach ulcers years ago, Helicobacter Pylori has become the ever popular cause for peptic and duodenal ulcers since its discovery by two Australian doctors, Robin Warren, M.D., and Barry Marshall, M.D., in the early 80's.  Some doctors place the bacterium's involvement as high as 90%, however ulcer-inducing drugs, alcohol, and other lifestyle stimulants are still a more common factor in the development of these ulcers than given credit lately.

H. Pylori may be inhibited by raising stomach acid or lowering its pH, provided this is done before much damage is done by the bug.  This is the reason why people who manage to maintain normal stomach acid levels are generally asymptomatic and don't get ulcers unless a) they are taking specific drugs, b) they consume excessive amounts of alcohol (although alcohol itself inhibits  Helicobacter Pylori), or c) they supplement too much calcium and magnesium, which in turn can lower stomach acid levels too much.  Coffee consumption is another factor known to aggravate the symptoms of H. Pylori infections.

Unfortunately, people with
reduced acid levels frequently suffer from what they assume is elevated stomach acid (heartburn, bloating, nausea, frequent burping), and as a result often take acid-lowering drugs or remedies.  By doing so, they encourage greater H. Pylori activity and thus increase the risk to develop peptic or duodenal ulcers, pancreatic / gastric cancer, and mucosa-associated lymphoid tissue (MALT) lymphoma.  H. Pylori infections can also lead to some forms of arthritis (calcification, spurs), iron-deficiency anemia, and Vitamin B12 deficiency that may develop as a result of lowered stomach acid levels and damage to parietal cells which produce the intrinsic factor.  H. Pylori is further implicated with heart disease, gum disease, rosacea, asthma, and chronic headaches or migraines.

If patients had indeed high acid levels (as some physicians still have
them believe), then why do symptoms improve when acid levels are

The confusion usually stems from the fact that esophageal reflux (GERD) causes heartburn from acid getting up into the esophagus, which doesn't have the acid-protective mucus coating of the stomach, and where - if acid was not reduced - could eventually cause ulcerations or esophageal cancer. In such an event, stomach acid will indeed have to be controlled by acid-lowering medications, as well as other lifestyle changes such as not overeating at any meal, not bending down or lying down following meals, and to sleep with the upper body more elevated until the reflux situation is resolved.  Bromelain supplementation with meals is often beneficial in such situations because of its anti-inflammatory and pro-digestive properties.

Because of its acid-inhibiting effect, H. Pylori actually
reduces the risk of developing esophageal adenocarcinoma, which is a form of cancer that may result from chronic esophageal reflux, and also Barrett's esophagus (Barrett's syndrome).  However, as mentioned above, H. Pylori increases the risk for developing various other cancers, including esophageal squamous-cell carcinoma.

Whether or not a
Stomach Ulcer has developed as a result of H. Pylori infection, acid-lowering drugs are routinely prescribed as part of the antibiotic therapy to either allow an ulcer to heal (if present), or to prevent one from developing while on antibiotics, which can be very irritating to the stomach.  Once the course of drugs is finished and an ulcer has healed, then normal acid levels should be maintained from there on.

After the discovery of H. Pylori, and once medical science accepted it as being a significant factor with ulcers, predictions were made that ulcers and related stomach complaints would become a thing of the past.  However, there are as many patients as ever complaining of stomach problems, including those who had been "cured" of H. Pylori.  The reason is very simply
low stomach acid - which had not been corrected as part of the treatment.  Antibiotic-resistant Helicobacter Pylori cases have now become a commonplace occurrence as well, and there are also plenty of patients who simply don't tolerate any of a number of antibiotics used in the treatment of H. Pylori.

Physicians don't generally test for Helicobacter Pylori unless a patient exhibits
gastric complaints, and even then, patients themselves have to frequently convince - or even beg their GPs to run a test after learning about H. Pylori through a news flash or reading about the long-term risks associated with its infection.  Unfortunately, if a patient suffers from non-gastric symptoms, there is little chance of the average practitioner relating a condition to a possible Helicobacter Pylori infection.

For example:  One of Ronald Roth’s patients developed asthma after having no prior history of this condition.  An Analysis revealed greatly reduced stomach acid levels and very high calcium and magnesium levels - also with no prior history. Although supplementing digestive aids to raise acid levels improved that patient's asthma, the fact that her bismuth and lithium levels were lower as well led me to suspect H. Pylori involvement, with turned out positive.  Following successful antibiotic therapy, her magnesium, calcium, bismuth and lithium levels returned to normal, her stomach acid returned to near normal without  the need for any more digestive supplements, and she became and remained completely asthma-free. Without eradicating the H. Pylori bug, she would have likely had to remain on asthma medication for much of her life, and/or there would have been the additional risk to develop other - potentially serious - H. Pylori -related medical conditions, including cancer.

Following are some "
Natural Remedies" that have been used with mixed results for H. Pylori:

A 5% solution of "
Manuka Honey" from New Zealand worked well in vitro to kill the bug, with almost two dozen studies backing up the claims, however I have yet to see a single patient ending up with an actual "cure" after taking Manuka Honey.  There are also claims that pure Alcohol taken on an empty stomach early in the morning will kill H. Pylori.  In the study only  one of the patients tried that approach, and although the symptoms did indeed disappear for a while, they eventually returned as severe as before.

Regular consumption of sulfur-containing sources such as
Garlic, Onions, or MSM is supposed to be helpful for H. Pylori symptoms according to some sources.  Similar claims are made for regular intake of Licorice and Cinnamon, larger amounts of Vitamin C, as well as Coconut oil, or spicy foods such as Hot (Chili) Peppers.  All had shown to somewhat inhibit Helicobacter Pylori in various trials, but again, none of these have really proven to be effective in actual clinical settings on a long-term basis.

Probiotic-types of remedies (friendly bacteria) consisting of Lactobacillus Acidophilus and Bifidus - although not a cure in themselves - are an important addition to any therapy for H. Pylori infection to help inhibit the bug, and to counteract any headaches, early-morning nausea, or general dyspepsia associated with low stomach acid alone, or following antibiotic therapy, with the acidophilus being best taken at bedtime.  Some patients only tolerate the lactobacillus acidophilus, without the bifidus.

An optional adjunct remedy in the treatment of H. Pylori is
Bismuth, which is also part of OTC products such as Pepto-Bismol.  Cellular bismuth and lithium levels routinely test below normal with low acid levels, respectively to upper stomach involvement (bismuth), and lower stomach / duodenal involvement (lithium).  The only problem might be that the high magnesium present in some products (that contain bismuth) generally worsens already low acid levels.

Mastic" is another remedy that has made the news.  It is derived from a tree resin (Pistacia lentiscus) that has been used as a food ingredient in the Mediterranean region for thousands of years, and which is now dried and sold in capsules.  Using 1-2g a day, there are reports of H. Pylori symptoms clearing in 90% of patients, and stool samples being H. Pylori-free in 80% of patients after only two weeks. In vitro studies have shown Mastic Gum to be effective against at least seven strains of Helicobacter Pylori, and an increasing number of human trials show similar results, backed by urea breath tests coming back negative.

A number of scientific studies around the world are currently being conducted, including trials to find out whether killing H. Pylori in the oral cavity by chewing mastic gum - not just in the stomach alone – would more permanently eradicate the bug.  Unfortunately, as is the case with many therapies and remedies, mastic (mastica) is not tolerated too well by a small percentage of patients who report stomach upsets similar or even worse compared to the discomfort experienced from the H. Pylori bacteria itself. Most patients however experience no problems during the two week mastic treatment, however despite the promising results of some of the above studies, there have been other clinical trials conducted with mastic / mastica that showed no efficacy whatsoever.

Sulforaphane is a promising compound that inhibits extracellular, intracellular, and antibiotic-resistant strains of Helicobacter Pylori.  This effect was identified by scientists at the Johns Hopkins University School of Medicine in Baltimore while investigating sulforaphane - one of a class of chemicals called isothiocyanates - for its protective effect against cancer.  Sulforaphane is found in broccoli and other cruciferous vegetables such as cauliflower, cabbage, and kale, with broccoli sprouts containing any- where from 30 to 50 times the  concentration of the chemical as contained in the mature plants.  Daily
recommended amounts of sulforaphane from broccoli sprout extracts are in the 200 - 400 mcg range. According to the above study, "The dual actions of sulforaphane in inhibiting Helicobacter infections and blocking gastric tumor formation offer hope that these mechanisms might function synergistically to provide diet-based protection against gastric cancer in humans."

Most patients who don't produce enough stomach acid will continue to experience problems, even if antibiotic therapy - or any other "natural" approach - has successfully killed the bug, but not everyone necessarily always suffers from "heartburn"- like symptoms, or bloating.
Low Stomach Acid can be a factor with allergies, asthma, headaches, chronic fatigue, non-specific aches and pains, osteoarthritis, osteoporosis and other calcium metabolism-impaired problems -- all the way to various cancers.  Many of these complaints are rectifiable by normalizing stomach acid, and from clinical observation, researchers are convinced that even several non-gastric types of cancers could be prevented, since they never seem to develop in the presence of normal acid levels.

To help the symptoms, or until any of several possible causes for low stomach acid are resolved, a digestive aid containing
Glutamic acid + Betaine + Pepsin should be taken with every larger meal. Some patients also have good results using Lemon or Lime Juice.  The only contraindications are gastritis, the presence of an ulcer, or when stomach acid levels are not low, which would prohibit the use of acid-raising supplements, however Bromelain may be a consideration in such cases for its anti-inflammatory effect, and for providing digestive support.

When antibiotics
and natural approaches have not been successful in eradicating Helicobacter Pylori, or when there is intolerance to most of the remedies that are usually helpful with low-acid symptoms, than regularly drinking Pineapple Juice with meals, or sipping it slowly throughout the day may be another option that has helped many patients keep their symptoms to a minimum and improve general digestion.

Copyright © 2005 HealthSmart Nutrition. All rights reserved.
Revised: May 23, 2006

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