Julianna's Battle With IBS, Weight Gain, And The Common Pathogen Helicobacter Pylori: A Case Study

Helicobacter pylori (H. pylori) is a type of bacteria that can be found in the stomach. It may affect the protective lining and is associated with conditions like gastritis or peptic ulcers. It is estimated that up to 50% of the world's population harbors this bacteria. Many are exposed in childhood and never develop symptoms. When symptoms do occur, they may include indigestion, frequent belching, bloating, feeling full long after a meal, abdominal discomfort, mood changes, and/or anxiety. Some individuals might also experience changes in bowel habits, mineral imbalances, and low-grade gut inflammation.

Another common issue associated with this bacteria is hypochlorhydria or low stomach acid. H. pylori produces an enzyme called urease that can affect stomach acid levels. Healthy levels of stomach acid are important for digesting food and absorbing nutrients. Often, a pattern of hypochlorhydria is observed alongside imbalances in gut bacteria and digestive enzymes.

Long-term presence of H. pylori may contribute to chronic gastritis, chronic dyspepsia, and other stomach issues. Therefore, it is important to address this bacteria, especially if symptoms are present.

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CC: Bloating, Gas, IBS

Julianna is a 26-year-old who was diagnosed with IBS in college. She has been experiencing extreme bloating after eating any food. She reports that her PCP was no help, and she also has seen a gastroenterologist for an endoscopy and was told she had stomach polyps, inflammation, and stomach erosions but was negative for celiac. She states, "They tried to have me take Protonix, and when I questioned, they did not really have an answer. " She also has alternating diarrhea and constipation, gas, headaches, anxiety, sugar/sweet cravings, and skin breakouts. She reports a 15 lb weight gain and that she is having difficulty maintaining a healthy weight.

Additional History:

She is 5'0 feet tall and weighs 142 lbs with a Body Mass Index (BMI) of 27.7 (desired BMI 18.5-24.9). Her past medical history also includes anxiety, for which she tried Lexapro without positive results. She also has struggled with acne and tried both oral doxycycline and amoxicillin a couple of years ago. She is currently off all medications. She has daily bowel movements that fluctuate from loose to constipated, and not feeling like she empties fully. Her diet consists primarily of whole foods but few carbohydrates. She reports that spinach and lettuce typically cause diarrhea. She consumes only 24 ounces of water daily. She consumes rare alcohol at social events and does not use tobacco or illicit drugs. She exercises three days per week, doing barre and cardio. She sleeps an average of 6 hours per night and reports her stress level at a 10/10 recently.

Initial GI-MAP Test

GI-MAP Analysis

Enteroinvasive E.coli/Shigella is present. These bacterial strains normally live in the intestines of people and animals. Most E. coli are harmless and actually are an important part of a healthy human intestinal tract. However, some E. coli are pathogenic. We are typically exposed via fecal contamination of beef, milk, or unpasteurized juice. Exposure can also occur from animal handling.

Helicobacter pylori (H. pylori) is also present at low levels. This pathogen is highly transmissible through saliva, feces, and/or vaginal secretions. It produces an enzyme called urease. This enzyme makes your stomach acids less acidic, a condition called hypochlorhydria. Julianna has many symptoms that may be associated with H. pylori, including changes in bowel habits, gas, bloating, headaches, anxiety, and skin breakouts.

Commensal or Keystone bacteria are the 'good bacteria' we want to have healthy levels of in the gut. Enterococcus spp. is low, which indicates insufficient levels. Lactobacillus spp. is elevated, which indicates maldigestion and possible excessive carbohydrate consumption, although she did report eating a lower-carb diet. Bacteroidetes and Firmicutes are considered large classes of bacteria that the individual strains fall under. Both large classes are elevated, indicating maldigestion, possibly excessive protein intake, and poor health of the gut lining as well as leaky gut.

Opportunistic bacterial overgrowth of Staphylococcus aureus, Streptococcus spp., and Methanobacteriaceae (family) is likely due to low stomach acid and maldigestion of food.

Interventions:

Julianna's protocol included 90 days of diet and lifestyle recommendations and supplementation. In month one, we focused on optimizing the detox and drainage pathways, reducing inflammation, repleting nutrients and minerals, and improving digestion. Here are the supplements we used:

Cellcore Advanced Tudca, 1 pill twice per day with or without food (Bile and liver support)
Cellcore Bowel Mover, 1 pill in the AM, 2 pills in the PM with or without food (Promotes regular bowel movements)
Cellcore Bio Toxin Binder, 2 pills twice per day with or without food (Promotes detoxification)
doTERRA Life Long Vitality pack. 2 of each in the am with food and two of each with food at lunchtime. (Replaces vitamins/nutrients, antioxidants, omegas, and cell protection)
doTERRA Terrazyme, 1 pill with each meal (Digestive enzyme)
Biotics Research, Immuno-gG, 2 pills three times per day on an empty stomach (Supports immune function)
doTERRA Turmeric, 1 pill twice per day (Inflammation)
doTERRA Copaiba, 1 pill twice per day (Calms nervous system)

Months two and three focused on addressing the pathogens, supporting the growth of beneficial bacteria, and promoting gut lining health. Supplements included:

Custom Probiotics, Adult Formula CP-1, 1 pill twice per day on an empty stomach (Probiotic)
Seeking Health Saccharomyces Boulardii, 3 pills twice per day on an empty stomach (Probiotic)
Biotics Research L-glutamine, 2 tsp twice per day (Supports healing of gut lining)
Designs for Health Probiophage, 1 pill twice daily with food (For E.coli)
Allergy Research Group Mastica, 2 pills twice per day on an empty stomach (For H. pylori)
doTERRA GX Assist, 1 pill three times per day with food (For Opportunistic bacterial overgrowth)

We also focused on diet and lifestyle modifications during the entire protocol and beyond. Rebalancing her lifestyle in terms of stress management and sleep prioritization are key components of the healing process. Suggestions included:

Whole foods based diet, eliminating gluten, sugar, and dairy.
Adding in 25 grams of fiber daily.
Staying hydrated by consuming half her body weight in ounces of water per day.
Stress management - using techniques like meditation and calming essential oils such as lavender.
Continuing to prioritize sleep with the goal of 8-9 hours of uninterrupted sleep.
Utilizing detox baths with Epsom salts, baking soda, apple cider vinegar, and hydrogen peroxide three times per week at night.
Gentle exercise, including walking after meals.

After following the three-month protocol, this is what Julianna said, "The last three months, I have had way less bloating, more regular bowel movements, and last time I checked, I had lost 9 pounds since August! There are some days I do feel more bloated than others, but I feel like that is normal. This process has made me feel sooooo much better!!"

One month after Julianna completed the protocol, we retested. Below are her results.

Repeat GI-MAP Test

GI-MAP Analysis and Interventions

C. difficile is no longer detected. H. pylori is no longer detected.

Commensal balance has improved overall. She will continue probiotics and increase fiber.

She still has some opportunistic bacterial overgrowth which is part of the picture of dysbiosis. On her follow-up protocol which was 60 days in length, we used GI Microbe-X 1 pill twice daily on an empty stomach to help manage the opportunistic bacteria.

Her SIgA is slightly lower, which can happen after the process of addressing pathogens. In order to support this, we utilized Douglas Labs Colostrum, 3 pills twice daily on an empty stomach. In addition, we continued supporting the gut lining and began working more on her metabolic health. She is also continually working on rebalancing and making stress management, sleep, and water intake a priority.

After her 60-day protocol, here is what Julianna said "Before my protocol, I was bloated after EVERY single meal, no matter if it was a healthy meal or not. I started protocol in October at 140 lbs. On December 24th, I was down to 136. The last time I checked at the end of February, I was at 133. I think I look and feel less puffy, especially in my face, if that makes sense! It was also interesting because I did not change anything about my workouts and still continued to do barre classes 3 days per week and lost that weight just by the supplements and changing my diet. Overall, I look and feel 1000 times better since I started working with you, and I couldn't be more thankful for you for helping me when no one else would!"

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Summary

Gastrointestinal ailments are among the most common issues in society. It is estimated that approximately 60 to 70 million people in the U.S. live with a digestive disorder, H. pylori being a very common one. It's important not to ignore symptoms as they are often easier to manage when they first arise. Gut health takes time to support. However, the longer you wait, the more challenging it can be. Over time, we can begin to normalize our symptoms and believe the lie that "this is just the way I am." It's important for you to know that you are not alone and you do not have to live with chronic digestive symptoms. You, too, can support your gut health and live a vibrant life, just like Julianna! The first step is to receive a proper diagnosis which can be achieved through high-quality stool testing. Next, working with a practitioner that creates a protocol specific to your individual needs that encompasses dietary and lifestyle modifications in addition to proper supplementation is key. Supporting your gut health will improve your overall wellness because, as Hippocrates said, "All disease begins in the gut."