The H. Pylori Controversy: Does it Really Cause Heartburn, Acid Reflux, and GERD?

by Jordan Reasoner

h-pylori

This little bacteria…

It infects more than 50% of the world’s population.

Flip a coin and that’s the probability you have it living inside your GI tract right now.

But is it hurting you? Or maybe, just maybe, the infection is helping you…

There’s evidence linking this infection to ulcers and stomach cancer. But then again, there’s evidence it may play an important role in your immune system and gut flora.

This is the controversy of H. pylori.

And this is what we’re going to dive into in this article.

How Two Hardcore Scientists Discovered H. Pylori

H. pylori is a bacteria. It’s full name is Helicobacter pylori.

It was unknown until two hardcore scientists discovered it in 1982.

See, back then it was commonly believed that stomach ulcers were just a byproduct of stress. But these two Australian scientists, Barry Marshall and Robin Warren, didn’t believe that.

Marshall and Warren discovered a bacteria (H. pylori) and decided to take biopsies of patients with stomach ulcers and gastritis. They formulated the hypothesis that H. pylori was actually the cause of such G.I. disorders.

The problem was that they needed a way to prove it. Unable to run trials on mice (H. pylori can’t infect mice) and unable to get approval for human studies… Marshall infected himself with H. pylori and, after developing precursory ulcer symptoms, biopsied his stomach and found the suspected culprit. He proceeded to treat himself with antibiotics to get rid of the infection and made a full recovery.

That’s dedication to science!

The Evidence Against H. Pylori

This is where things start to get interesting. Since 1982, this infection has been studied extensively beyond stomach ulcers and gastritis… and these days it’s also linked to things like:

  • NSAID gastropathy (inflammation due to use of NSAIDs)
  • Gastric carcinoma (stomach cancer)
  • Lymphoma (cancer/tumors in the lymphatic system)

…not to mention disorders outside of the G.I. tract like: ischemic heart disease, ischemic cerebrovascular disorders, rosacea, raynaud’s syndrome, food allergy, Vitamin B12 deficiency, and open-angle glaucoma. It’s also been noted that H. pylori infections can increase inflammation throughout the entire body.

That’s a whole lot of bad stuff. So far, H. pylori has a bad reputation.

The evidence gets even worse, just look at how prevalent H. pylori is in the following conditions:

  • 80-100% of those with duodenal ulcers
  • 70% of people with gastric ulcers

And yet, we aren’t totally sure how it’s spread. We do know that if you live with someone with an H. pylori infection, your chances of developing an infection are much greater. Whether it’s passed through saliva, fecal matter, food, or animals is still up for debate.

Also, one school of thought is that these infections could start in early childhood and it’s actually your genetics and lifestyle choices that dictate whether it results in something harmful like gastritis, ulcers, or stomach cancer.

Those with low stomach acid may be at a greater risk, too.

Stomach acid not only helps to digest food, but it also prevents infections. As you get older, your stomach acid levels can decrease (a condition called hypochlorhydria) and it may be why the population over 50 has a higher prevalence of infection.

Not only that, but H. pylori can suppress stomach acid levels, making the cycle even worse.

According to the Textbook of Functional Medicine, low stomach acid predisposes one to the growth of H. pylori and is also linked to SIBO and inadequate Vitamin B12 absorption. It’s also noted that low levels of vitamin C, and vitamin E in gastric fluids promote the growth of H. pylori. And while there aren’t decisive studies showing that H. pylori is the direct cause of heartburn and acid reflux, there is an implied association there.

It’s not looking good for this bacteria so far. Here’s how to tell if you have it living inside you right now.

Signs and Symptoms You Have H. Pylori

The data suggests that 85% of people infected with H. pylori never experience symptoms, but here’s a few clues this is something you might have right now:

  • Burning or ache in the abdominal region – worse on an empty stomach
  • Nausea
  • Loss of appetite
  • Burping
  • Bloating
  • Weightloss

Of course, this list of symptoms could be from many different root causes, so it’s important to make sure you get tested to know for sure. The following tests are ways to find out if your symptoms may be caused by H. pylori:

  • Breath test (C urea)
  • Serology
  • Blood test for H. pylori antibodies
  • Stool antigen test (like the BioHealth 401H)
  • Intestinal biopsy (histology, culture, rapid urease test, PCR)

Like any modern day medical testing, each of these has its own drawbacks with regards to how invasive it is, reliability and sensitivity, and the cost.

Another complication is there doesn’t seem to be a “gold standard” test that exists, as this article puts it, A combination of methods tested against one another may be the best approach to confirm the presence (or absence) of H. pylori infection.

Polymerase chain reaction (PCR) from an intestinal biopsy seems to be the most sensitive and specific, but it’s pretty invasive because it requires an instrument to be inserted down your throat. And there’s a debate about the tissue selection. It’s possible (not sure how much yet) for the selected tissue to be negative but surrounding areas positive (they just weren’t sampled).

In our experience (and our own battle with H. pylori), the Stool antigen test from a BioHealth 401H has worked well.

So You Have H. Pylori – How Do You Treat It?

This is where the controversy comes in…

Most doctors just treat it if there’s a diagnosed ulcer, but you can still have an infection, and not a diagnosable ulcer. It’s a little concerning given the evidence that H. pylori infections are linked to greater chances of developing other disorders/diseases aside from stomach cancer, chronic gastritis, and ulcers.

But if you test positive for H. pylori… but you don’t have any symptoms – is treatment worth the risk?

There are some natural H. pylori remedies out there, like bismuth subcitrate, deglycyrrhizinated licorice, and mastic gum resin. But most H. pylori infections in the modern medicine setting are primarily treated with a powerful cocktail of antibiotics.

It’s usually a combination of antibiotics, like amoxicillin, lansoprazole, and/or clarithromycin along with an antacid regimen (usually some PPI). While this can and does work, antibiotics as a viable means for treating H. pylori may not be so effective in the future.

Plus, if you follow our work, you know that a healthy gut flora is critical to a happy gut, so a heavy dose antibiotic protocol isn’t going to support that. In fact, one study actually linked antibiotic eradication of H. pylori to fungal growth in gut mucosa, which actually makes sense. You are literally trying to destroy a bacteria, and sadly the antibiotics aren’t selective for just one species of bacteria – you’re taking out the good guys, too.

And that’s where things get tricky.

The gut bacteria isn’t so black and white. There are some bacteria that are symbiotic (they help us we help them), some that are pathogenic (they only harm us), but then there are some more middle of the road. It’s currently thought that these bugs don’t t really help us or hurt us, depending on the circumstances.

But while evidence on specific strains of bacteria being good or bad is sorted out, what is accepted is that you want a large diversity of bacterial species in the gut. And heavy antibiotic therapy definitely reduces the number of species in the short-run and might be an issue in the long-run.

So Is H. Pylori Good or Bad?

Up until this point, you might be thinking H. pylori is definitely a bad guy and should be killed off. But that’s not the full story…

One of our mentors, Chris Kresser, has a great talk on this (you can check it out here) – and he uses H. pylori as an example of a middle of the road kind. In the talk, he mentions this one study where H. pylori was actually shown to help prevent against asthma in animals, but only if it was contracted early enough.

H. pylori infections introduced later in life are associated with greater amounts of inflammation and greater risk of stomach cancer. But it’s possible the earlier in life H. pylori is introduced, the more it serves as a protective factor. Timing and bacterial cross-talk, though minimally understood, are proving to be critical and fascinating factors in health.

During Kresser’s talk, he reviews a study which focuses on people from an area called Sardinia, where the population was infected with Malaria (usually a super bad infection). Those with a trait for sickle cell anemia were able to live with the infection without any problems. In the 1950s, there was a movement to eradicate Malaria from this island. Soon after it was completely eradicated, the onset of autoimmune disease, in the form of type 1 diabetes and multiple sclerosis, spiked through the roof. The theory is that the Malaria infection was doing more than ever thought – that it was affecting and modulating its host’s immune systems, preventing them from getting these other diseases.

When this same theory is applied to chronic infections, it goes like this: if you get a chronic infection early enough (like the Malaria example), then your immune system development and function are governed and influenced by it and it could begin to help you and removing it may cause unknown and detrimental effects.

Kresser says it like this: “Imagine you’re standing and facing someone, and you both have your hands out and you’re leaning into each other, and all of a sudden somebody steps away, you’re going to fall down.”  

So the bottom line: Just because you have an H. pylori infection doesn’t mean you will develop gastritis, cancer or an ulcer… and the symptoms of heartburn, GERD, and acid reflux.

You may not even show signs or symptoms, and that may be a good thing. It may be how it’s supposed to be… unless you have ulcers, or in our opinion, any other digestive related problems.

Our current point of view is that if you’re struggling with ulcers, gastritis, heartburn, GERD, acid reflux, or other GI symptoms AND you test positive for H. pylori… it’s probably a good idea to treat it.

The most common reason being: H. pylori has been shown to suppress stomach acid, which you need to fix to finally get rid of the symptoms of heartburn once and for all…

Not to mention properly digest and absorb the nutrients from your food.

How to Treat the Root Cause of Heartburn

Contrary to what you might have been told, there are 7 root causes of heartburn, acid reflux or GERD.

And it starts with understanding that the main issue isn’t that you aren’t producing too much acid. Instead, it’s actually the opposite – you’re likely producing too little acid.

The root cause of this low stomach acid can be multifactorial, but we do know that H. pylori infections can play a huge role.

And after overcoming this issue myself and helping 100s like me, we decided to do a dedicated 3-hour presentation on how to overcome heartburn naturally.

I urge you to check it out here: http://heartburnhelp.scdlifestyle.com

During this presentation, we’ll help you understand the most important short-term and long-term strategies to start naturally taking control of this condition.

What we cover during the ‘Getting Rid of Heartburn’ presentation:

  • The 3-step “rest, repair, and reset” to unlock your body’s natural ability to heal from the damage of years of antacid pills
  • How to break free of the dependence on pills holding you back from life-changing restoration of healthy stomach acid levels
  • The sneaky little root causes that keep your stomach acid low – even after you’ve stopped the pills – and keep the cycle of heartburn raging
  • What you MUST be avoiding in order for your stomach to heal (or the symptoms will come right back)
  • The step-by-step process we’ve used to naturally get rid of heartburn and restore normal stomach acid levels (even if they’ve been on PPIs for 20 years)
  • Why food is critical – and not so critical – for your long-term success getting rid of heartburn
  • A simple method for cultivating normal stomach acid levels that trigger great digestion… even for some foods you couldn’t tolerate before
  • Specific supplements to take – and other ones to avoid – on your road to healing the stomach and fixing your heartburn
  • Why H. pylori, SIBO, Hormones, and other root causes could be the REAL reason you’re still suffering from heartburn, even though you’ve done everything else right
  • Plus, much more…

Click here to get this life-saving information: http://heartburnhelp.scdlifestyle.com

– Jordan

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About the author

Jordan Reasoner Jordan Reasoner is a health engineer and author. He was diagnosed with celiac disease in 2007 and almost gave up hope when a gluten-free diet didn’t work. Since then, he transformed his health using the SCD Diet and started SCDLifestyle.com to help others naturally heal stomach problems. You can check out his story here and find him on Google+, Facebook or Twitter.

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{ 21 comments… read them below or add one }

Stefi May 20, 2015 at 11:54 am

Jordan, perfectly written article! I learned of you & Steven in 2013 on my quest to better health for my new diagnosed Hashimotos , my mom had all the symptoms that you wrote about H Pylori -suffered years, ulcers, PPI use, then other big health events too, Rheumatoid ,a major stroke & battles w.infections, the first one after a hip break. I would of loved to of had the knowledge you share then… As for me, I would not be surprised if her beginning was Hpyori. And wonder if I have, (partly because of extensive travel in my childhood.) I feel antibiotics are not bad but now believe a person must repopulate as much as possible. Wish I would of known then for my mom . Thanks again for all you guys do!

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Lori Jo Berg May 20, 2015 at 6:39 pm

Thanks for sharing Stefi, we appreciate it!

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Tracy W May 25, 2015 at 5:17 pm

I have pernicious anemia which caused a severe B12 deficiency before it was finally diagnosed. I’m wondering whether there is an H pylori connection with PA.

PA appears to be much more common in the UK than here in the US. This leads me to believe there is a genetic component to this as well (it’s known to run in families), plus maybe the Standard American Diet (gluten and fats) tossed in for good measure.

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Lori Jo Berg May 25, 2015 at 11:38 pm

Hi Tracy, it would be a good idea to get tested in this situation and if you are in need of a great practitioner, please go here: http://scdlifestyle.com /practitioners/

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Sonja May 25, 2015 at 11:51 pm

Hi. Thank you for writing an important article about H. Pylori. I am having a discussion currently with my functional medicine doctor about H. Pylori and low ferritin levels (plus GI disorders). Even after two years of taking 90 mg of iron, HCL with pepsin, enzymes, glutamine and eating well, I can only raise my ferritin up to
15 ng/ml which is incredibly low. It was a 5 before. 🙁
Unfortunately, H pylori needs iron to survive and thrive and steals it from the host. A good article on this subject can be found at : http://www.irondisorders.org/Websites/idi/files/Content/854291/hpylori.pdf
I am a nutrition student, eat a whole foods diet and a SCD diet, and still have gut issues and low ferritin symptoms. Hopefully I have found the answer to my problems. I did test positive for H pylori on a stool test. Good luck to everyone and I hope that this information helps. 🙂

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dini September 3, 2016 at 1:11 am

I hve both ulcer and acid reflux.the test also show H.pilory bacteria posive. I expreriance bad breath (like feaces or expired milk)that go had in hand with acid reflux , my stomach also produces excess Hcl acid ,heart burn and pain in the stomach.
Could H.pilory bacria be the cause of problem?
I walk up with a good day but everythiing turn around after food.I stop eating fatty food milk suger an acid drinks. Plz help me

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Mariel Heiss September 6, 2016 at 4:36 pm

Hi Dini – h. pylori can cause a lot of symptoms – including low stomach acid which can cause acid reflux.

I suggest checking this out: http://heartburnhelp.scdlifestyle.com/

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Jacob Whittington December 10, 2015 at 3:42 pm

Helicobacter Pylori, the cork-screwed shaped bacteria, has been associated with most cases of human Gastritis. H. Pylori is considered the most popular cause for Peptic and Duodenal Ulcers.
A very large portion of the population has the H. Pylori bacteria in their digestive tract. When the bacteria enters the digestive system, it buries itself in the heavy mucus lining, of the stomach and is held in check, by the strong hydrochloric acid, produced by the stomach’s parietal cells. The bacteria starts to proliferate, when the hydrochloric acid is no longer strong enough, to keep the bacteria in check and when the mucus lining thins. Initially the bacteria will destroy the Hydrochloric acid producing cells (parietal cells) in the stomach. The bacterial will then attack the lining of the stomach and duodenal.
As a normal part of aging, many people develop Hypochlorhydria. Hypochlorhydria is the reduction in the strength of the Hydrochloric acid, produced by the stomach parietal cells. This allows the bacteria to start growing. The use of antibiotics, antihistamines, PPIs (Proton Pump Inhibitors), and acid reducing medications, stops the production of acid and allow the proliferation of the bacteria. Mucus reducing medications also allow the bacteria to grow.
H. Pylori infections can also lead to some forms of Arthritis (calcification, spurs), Iron deficiency, anemia, and vitamin B-12, calcium deficiency. H. Pylori is also implicated with Heart Disease, Arteriosclerosis, Arterial Fibrillation, Asthma, Resaca, Headaches or migraines. It also increases the risk of developing Peptic, or Duodenal ulcers, Pancreatic/Gastro Cancer, and mucosa-associated Lymphoid Tissue (Malt) Lymphoma.
Many people, cured of H. Pylori will continue to complain about stomach problems. This is mainly the result of Hypochlorhydria (low stomach acid), that has not been corrected as part of their overall treatment. People that maintain a proper pH balance in the stomach are generally asymptomatic and do not have problems with H. Pylori bacteria.
The best method for diagnosing low stomach acid is a pH diagnostic test, pH capsule test, or gastrogram. A pH diagnostic test, will allow the doctor to quickly determine if a person is not producing strong enough acid (hypochlorhydria). It will also allow the doctor to determine the correct quantity and type of natural medication, necessary to bring the digestive back into balance.

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salaad March 15, 2016 at 3:02 pm

my idea should go lab and test it before they go to doctor, second some doctors do not advise ptient for stool analysis but prescribe a medication and that is awful

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James October 30, 2016 at 7:28 am

Admittedly I must agree with you there. It’s like with infections; they do not know whether it’s a viral, bacterial or fungal infection, yet will dish out antibiotics, for example, without swabbing or testing to see what type of infection it is, and doing so can actually be quite harmful.

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Esther April 27, 2016 at 6:35 pm

Currently treating my H. Pylori infection, had symptoms for year (blotted stomach and belly, gas, some pain a loose stool) did a feacal antigen test and I was positive!!! I’ve been to the Dr. With the symptoms and checked for Celiacs but was negative so I was told it was just IBS and I needed to just leave with it and control with the diet!! I work for a diagnistics company so I did my own test! 2 more days, I cannot wait to see if symptoms go away and also the bacterium.

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Adam August 20, 2016 at 5:33 pm

I have tested positive for h plori but my main symptoms are more daily diarrheoa and undigested stools passing. My doctor is refusing to treat the infection at present as it is ‘a common condition’ !

Could the h pylori be a cause of my daily diarrheoa ?

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Mariel Heiss August 22, 2016 at 4:22 pm

Hey Adam – h. pylori doesn’t typically cause diarrhea, but it isn’t unheard of. We encourage you to seek out a 2nd opinion if you’re unsatisfied with the care your doctor is providing.

Digestive enzymes can help with diarrhea and undigested food, too: http://scdlifestyle.com/2013/07/who-needs-digestive-enzymes-and-how-to-take-them/

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Jessica September 11, 2016 at 8:32 am

I was pervisly tested positive for h pylori and some other thing in my stomach but my problem is now I am having a stool live after everything I eat is that common and at time it looks like blood in the stool. They also said they checked for stomach cancer (and it wasnt stomach cancer)because been and still are losing weight can you give me and answers do you think I need to find another doctor

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Mariel Heiss September 12, 2016 at 2:46 pm

Hi jessica – thanks for reaching out. We definitely recommend you get a second opinion from another doctor, as we aren’t qualified to give you any medical advice this way.

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Deezer September 30, 2016 at 2:13 pm

According to
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177467/, stool testing for H. Pylori is difficult and often inconclusive. What does Biohealth do to ensure accurate results from the 401H? What research have you done (vs other H. Pylori methods) to show that it is accurate?

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Mariel Heiss October 4, 2016 at 11:42 am

Hi Deezer – we have great results with this test, but you can also ask your MD for an h. pylori test if you’re not comfortable with stool testing

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James October 30, 2016 at 7:18 am

Now I have an interesting fact. Me and my mum both have GORD/GERD, but we find we are the total opposite in terms of heartburn triggers. For example, my mum finds her burning is more severe when her stomach is empty, where as I find mine is worse after eating and sometimes am unable to eat much, if at all. Also, my mum finds her heartburn worse when sitting or standing and gets better when she lies down, where as mine gets much worse when I lie down or bend down, and sometimes I can’t lie down and have to stand or sit up.
I am aware of stomach ulcers possibly being caused by H. pylori, and stomach ulcers are not an uncommon side-effect of NSAIDs and corticosteroids, but if you think about it, these drugs can weaken your immune system which could contribute to H. pylori infection.
A gastroscopy has confirmed that I do not have a stomach ulcer and my GORD has been defined as “idiopathic”, make of that what you will.

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Mariel Heiss October 31, 2016 at 3:36 pm

Hi James – thanks for commenting.

Sorry to hear both you and your mom are suffering with GERD. I encourage you both to check out our heartburn help program – no matter what your heartburn symptoms are, it helps you address the root cause and heal: http://heartburnhelp.scdlifestyle.com

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Chris Davies November 12, 2016 at 3:52 pm

You say it’s almost always the case that it’s low acid that’s the problem, but what if you’re under permanent stress from years of tests and getting nowhere or you just Happen to have an ulcer or erosive esophagus. Surely these wouldn’t be caused by low acid.

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Lori Jo Berg November 14, 2016 at 2:04 pm

HI Chris – great question. If an erosive esophagus is caused by acid coming back up to that area, the most likely cause is a malfunctioned LES which can be caused by pressure in the gut. Pressure in the gut is often caused by a leaky gut (gut infection such as SIBO), food intolerance, poor diet, etc.) Low stomach acid allows for unwanted microbes to grow due to the fact that the PH is too alkaline and not acidic enough. It is very rare we see someone with too much stomach acid. Hope that helps clear up the confusion.

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