Helicobacter pylori is a common gastrointestinal bacterial presence worldwide. Humans have been co-evolving with this bacterium for over 50,000 years, and over 50% of the global population may carry this in their gut. H. pylori has been associated with stomach issues such as ulcerations, gastritis, and acid reflux. The bacteria can also be linked to symptoms like nausea, loss of appetite, excessive burping, weight changes, and stomach discomfort. A functional approach to managing H. pylori may include medications and/or herbal and botanical options intended to support a balanced bacterial environment.
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CC: Acid Reflux, Anxiety, Irregular Bowel Movements
Mary was a 27-year-old female experiencing acid reflux, constipation, bloating, anxiety, sleep issues, hair loss, recurrent vaginal yeast infections, and PMS. Mary was diagnosed with stress-induced gastritis and a list of food sensitivities from her previous practitioner. Mary had moved frequently over the last 5 years and had a recent DNC, resulting in her being hospitalized with a panic attack and a diagnosis of anxiety and depression. Mary was prescribed antidepressants and sleeping aids for 2 months with slight improvement, but the anxiety and stress returned without a known cause.
Additional History
Prior to our initial session, Mary had recently moved to the US and started a "healthy, elimination diet" but began experiencing pain under the ribcage. She consulted with her functional medicine physician for a natural approach and was advised to try ginger tea with echinacea, omega-3s, adaptogens, vitamin D, lactobacillus rhamnosus, and coconut charcoal, alongside a low FODMAP diet. Mary experienced some improvement with this protocol but was still experiencing constant reflux when we met and a very restrictive diet.
Initial Lab Work
Comprehensive Stool Test Results:
- Helicobacter pylori high 2.0e3, negative virulence factors (normal <1.0e3)
- Dysbiotic flora high, elevated bacillus, enterococcus, staphylococcus spp., streptococcus spp, methanobacteriaceae family, prevotella spp, fusobacterium spp
- Parasite: blastocystis hominis high 4.50e6 (normal range <2.00e3)
- Elastase-1 low normal 415 (optimal range > 500 ug/g)
- Secretory IgA low 135 (normal range 510 - 2010 ug/g)
Small Intestinal Bacterial Overgrowth Results- negative
Lab Analysis
Mary's lab work suggests three main areas that may be contributing to her symptoms:
Presence of Helicobacter pylori in High Amounts
H. pylori may decrease stomach acid production, which can impact digestive enzyme production. This can potentially expose individuals to more infections (such as blastocystis hominis and dysbiosis) or create an environment where digestion is less efficient (low normal elastase), leaving large food particles to reach the intestinal tract where they may be utilized by undesirable bacteria.
Presence of Blastocystis hominis in High Amounts
H. pylori and B. hominis are often found together in gut testing and may contribute to anxiety, digestive issues, and a weakened immune system (low secretory IgA).
Low Secretory IgA or Immune Response
A low immune response can affect how well the body manages infections and tolerates foods. This is an important marker on a comprehensive stool test, and supporting it before, during, and after interventions may help achieve more successful outcomes.
Interventions:
- Consider DGL Plus by Pure Encapsulations: 1 capsule per day to help soothe the gastric lining and support relief from acid reflux symptoms
- Consider Vital 10 by Klaire Labs: 1 capsule per day, taken away from Candibactin AR, as probiotics may support a balanced gut environment
- Consider Mastic Gum by Jarrow Formulations: 2 capsules 2x/day between meals, as it may support digestive health
- Consider Candibactin AR by Metagenics: 1 capsule 3x/day, as oregano may support a balanced microbial environment
- Consider Herbulk by Metagenics: 1 tbsp per day with plenty of fluids, as increasing fiber may support digestive health
- Consider Interfase Plus by Klaire Labs: 1-2 capsules 2x/day between meals as a biofilm disruptor
- Consider Bismuth chewable: 2 tablets 2x/day for only 2 weeks, as it may support digestive health
- Consider l-Theanine by Pure Encapsulations as needed for supporting a healthy stress response
- Encouraged to work with our nutritionist to start incorporating a wide variety of foods and transition from the low FODMAP diet plan to help increase dietary diversity and support a balanced microbiome
Follow Up 4 Weeks Later
At our one-month follow-up, Mary reported feeling much better but still experienced occasional acid reflux. She was no longer constipated or having diarrhea and felt a significant reduction in overall discomfort, anxiety, and stress.
We continued supporting Mary's digestive health and microbial balance for approximately 4-6 more weeks by continuing mastic gum, Interfase Plus, DGL Plus, and Candibactin AR. Additionally, once the other previously mentioned supplements were finished, we added in SBI Protect by Ortho Molecular, S. Boulardii by Ortho Molecular, and Mega Guard by Microbiome Labs.
SBI Protect may help support low secretory IgA, which is important for maintaining a healthy gut and immune system.
S. Boulardii may support low secretory IgA, as well as help maintain a balanced gut environment.
Mega Guard may help support a healthy balance of stomach acid and microbial presence.
Repeat Labs After 8 Weeks of Treatment
Mary stated that she started to feel better after only 2 weeks into the supportive regimen. However, after 2-3 months, her acid reflux had significantly improved, and she was now H. pylori-negative on qPCR testing, which is a sensitive method for detecting H. pylori.
Small Intestinal Bacterial Overgrowth – did not run due to being negative initially.
Helicobacter pylori qPCR testing only- not detected, ruling in or out H. pylori prior to repeating full stool test panel.
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Summary
This case demonstrates how using the right testing with reference ranges can be helpful, especially before making significant dietary changes. Mary recognized that her anxiety and acid reflux were complex and required a comprehensive approach. This highlights the importance of understanding one's own body and symptoms and working with providers who are open to thorough testing and exploring root causes.
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