Stomach Bug – how to get rid of H. pylori

How does H. pylori survive in the stomach?

Unlike most other bacteria, H. pylori is resistant to the acidic conditions of your stomach because it is able to produce an enzyme called urease. This enzyme converts urea (a waste product produced by cells in the stomach) into carbon dioxide and ammonia. Ammonia is alkaline, so can neutralise hydrochloric acid in the stomach.

H. pylori swims using its ‘flagella’ which are projections off its surface that it can use to propel itself. H. Pylori swims to the protective mucus layer of your stomach where it is less hostile and easier to survive. Once H. pylori is settled in, H. pylori causes inflammation in your stomach lining, or gastritis. This can also reduce the amount of acid that your stomach produces, which makes it easier for H. pylori to survive.

Is all H. pylori bad?

The global prevalence of H. pylori is 43%, which means that almost 1 in 2 of us have it in our stomach. However, most people with H. pylori do not have symptoms or gastritis.

Bacteria living with us are usually symbionts, commensals, or pathogens. Symbionts give us a health benefit, commensals are typically not helpful or harmful, and pathogens are disease-causing bacteria. If so many people in the world have H. pylori without issues, is it really a pathogen, or could it be a commensal, or even symbiont?

There is some evidence that H. pylori may protect us from developing asthma and autoimmune inflammatory bowel disease. Both these diseases are immune-related, so H. pylori may help to train our immune system. H. pylori may also protect against gastroesophageal reflux disease, probably because gastritis leads to a reduction in stomach acid production.

However, we know that H. pylori is strongly associated with gastric cancer. So, if you test positive for H. pylori, eradicating it with antibiotics is strongly recommended.

How do the tests work

The most accurate, non-invasive test for H. pylori is a C13 breath test. These work by swallowing a urea pill containing carbon 13. If H. pylori is present, it will digest this urea by using the enzyme urease. This converts urea into ammonia (which neutralises stomach acid) and carbon dioxide. This carbon dioxide is now labelled with C13, which can be measured on breath.

Other tests include stool samples, which look for any H. pylori genetic material present, and bood tests to see if your body is producing any infection-fighting ‘antibodies’ specific to H. Pylori. You may also be referred for a camera examination called an upper endoscopy. During this examination, a camera will look for any inflammation, or gastritis, in your stomach and take tissue samples to look for any H. Pylori bacteria.

To mitigate the effects of antibiotics on the microbiota it is important to only take them when instructed to by a medical professional. After a course of antibiotics you can help replenish your microbiota by eating foods rich in probiotics and prebiotics.

How to get rid of H. pylori

H. pylori is treated with a strong antibiotic regimen called triple therapy. This includes two different antibiotics and a proton pump inhibitor (PPI). Two different antibiotics are used because H. pylori can become very resistant to antibiotics. The PPI helps to reduce stomach acid because antibiotics work best on living bacteria, and although H. pylori can survive in stomach, it can live easier if there is less stomach acid.

Unfortunately, the antibiotics are not specific, so not only will a course of antibiotics get rid of the H. pylori bacteria, but also your good bacteria that make up your microbiota which can cause an upset stomach.

How to make the antibiotics work better

There’s some evidence that probiotics can not only help to reduce the side-effects of triple therapy, such as diarrhoea, but also make the antibiotics work more effectively to get rid of H. pylori.

The probiotic strain with the most evidence for helping to get rid of H. pylori alongside antibiotics is L. reuterii DSM 17938. This is a probiotic strain unique to the products produced by BioGaia.

One study also found that drinking kefir twice per day may also improve eradication of H. pylori alongside antibiotics. Kefir is a fermented milk drink full of living, good gut bacteria.

Summary

Overall, H. pylori is a pesky stomach bug that affects many people across the world. Identifying H. pylori is easy and natural products in addition to antibiotics can help to get rid of this stomach bug for good.