It’s your first patient of the day. She comes in experiencing bloating and heartburn. You do a little digging and don’t find much—only that she mainly has issues after eating rich proteins like eggs or meat.
Because it seems like just another case of heartburn, you give her a prescription for an acid blocker and send her on her way.
This has been the standard approach for dealing with heartburn for decades, but the truth is this a dangerous model—and one that completely violates the principles of preventive medicine.
The Story of Barry Marshall and Robin Warren
For many years, it was commonly assumed that stomach ulcers were caused by stress. But two Australian scientists weren’t so sure.
Barry Marshall and Robin Warren felt there must be some other cause for ulcers, so they decided to investigate. In 1983, they published their results in The Lancet in a paper titled, “Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration.”
They found a new strain of bacteria, which they described as “small curved and S-shaped bacilli,” in a number of endoscopic biopsies from 100 patients presenting for gastroscopy. This newly discovered bacteria was present in almost all patients who had active chronic gastritis, duodenal ulcers, or gastric ulcers. They strongly suspected that this relationship was causal.
However, they needed a way to prove it. They found that the bacteria, later classified as Helicobacter pylori, couldn’t infect mice, and they weren’t able to secure approval for additional human studies, so they did the only thing they could: Barry Marshall infected himself with H. pylori.
H. pylori was present in almost all patients who had active chronic gastritis, duodenal ulcers, or gastric ulcers.
As they had hypothesized, Marshall soon developed symptoms of stomach ulcers. A biopsy of his stomach confirmed that H. pylori was present. He treated the infection with antibiotics and made a full recovery.
Thanks to some rather bold and unconventional thinking from these two Australian scientists, we now know that H. pylori infections can lead to a number of health issues besides ulcers, including heartburn.
Why Heartburn Is a Red Flag for H. pylori Infections
Let’s go back to the story at the beginning of this post. The patient complains of heartburn and bloating, especially after consuming protein like meat and eggs.
One of the things that we know is that when people have heartburn and an intolerance to digesting proteins, it means they aren’t producing enough acid. And now, post Marshall and Warren, we also know that the underlying mechanism for these symptoms could be an H. pylori infection.
In this video, I explain why the standard heartburn treatment is a dangerous model
H. pylori furrows into the lining of the stomach, where it suppresses parietal cells from releasing hydrochloric acid, which happens to be the enzyme we use to digest protein. It follows that when people get H. pylori infections in their gut, they experience bloating and heartburn when they eat a protein-rich meal.
Not only that, but when they have their acidic environment reduced from this type of infection, it sets the stage for gastrointestinal imbalances all the way down the GI tract. Our digestive systems need that initial step of acidity to change the pH of the gut and to neutralize any types of infections that may be ingested when we consume foods.
Standard GI protocols too often leave patients high and dry without seeing any meaningful improvements. You owe it to your patients to look beyond generic treatment plans and provide personalized care. But how?
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Standard GI protocols too often leave patients high and dry without seeing any meaningful improvements. You owe it to your patients to look beyond generic treatment plans and provide personalized care. But how?
Why Antacids and Acid Blockers Don’t Work
When people develop a pattern of heartburn and intolerance to proteins specifically, it’s likely that they do in fact have H. pylori infections. (Another tell-tale sign to be aware of is bad breath, which is due to bacterial overgrowth in the intestines.)
But when a bacterial infection is the cause of heartburn, this can lead to a bigger problem: attempting to treat the symptom rather than the cause, which is why the scenario at the beginning of this post is so common.
When people are given antacids to get rid of the burning symptoms of H. Pylori-induced heartburn, the neutralization of acids in the stomach makes the patient even more prone to reoccurring infections.
The traditional model of thinking, after all, goes like this:
- The patient has heartburn.
- Heartburn is due to an overabundance of stomach acid.
- The solution is to prescribe an antacid or acid blocker.
The problem? In the case of an H. pylori infection, low stomach acid is the cause.
This means when people are given antacids to get rid of the burning symptoms of H. Pylori-induced heartburn, the neutralization of acids in the stomach makes the patient even more prone to reoccurring infections. They actually need an asynchronous environment to get rid of the bacteria—that is, more acid in their stomachs, not less.
The Truth About H. Pylori
H. pylori is a bacteria with far-reaching effects on multiple systems of the body.
H. pylori has been shown to be very destructive to the vascular endothelium. In fact, there have been over a thousand papers published in the scientific literature since Marshall and Warren’s original 1983 work that show H. pylori is as dangerous to the blood vessels as the hepatitis C virus is to the liver.
Why is H. pylori so bad for the blood vessels? It finds its way into the blood vessels, destroys them, and acts as a precursor to atherosclerotic plaquing. Cadaver studies have shown that the bacteria is one of the key antigenic triggers for atherosclerosis and heart disease.
Over a thousand published scientific papers have shown H. pylori to be as dangerous to the blood vessels as the hepatitis C virus is to the liver.
Even worse, H. pylori infections can also be “silent,” with not a lot of heartburn or other symptoms. This subtle form is also a major risk factor for developing gastric carcinoma. (In fact, it contributes to up to 89 percent of stomach cancers.)
It’s also been shown that H. pylori can cross-react with the thyroid, and the bacteria has been identified as a trigger for things like Hashimoto’s hypothyroidism.
All of this put together means when a patient comes in with heartburn and they are immediately put on acid blockers and not tested for an H. pylori infection, there is a real risk for much greater health problems to arise.
Diagnosing and Treating H. pylori-Induced Heartburn
Let’s go back to this idea of low stomach acid as the cause of heartburn for patients with H. pylori infections, as it’s worth exploring why this is the case.
When food enters the stomach, the stomach distends and releases hydrochloric acid (HCl). HCl is vital for digesting food, particularly proteins and meats. Your body also needs sufficient stomach acidity to trigger the valve to the small intestine to open and to activate the release of additional digestive juices.
So why would low stomach acid cause symptoms like burning, heartburn, and indigestion? The valve that separates the stomach from the small intestine depends on proper stomach acid levels as a cue to open and allow food to pass into the small intestine.
HCl is vital for digesting food, particularly proteins and meats.
When the stomach environment is not acidic enough, the valve won’t open. This leaves the food to sit and putrefy in the stomach. The putrified food eventually moves up into the esophagus where the tissues become irritated.
This, in turn, causes many cases of heartburn to be misdiagnosed as resulting from high stomach acid levels.
Symptoms of low stomach acid that should alert you to check for H. pylori include
- Heartburn, bloating, burping, or gas within an hour of meals, especially meals with protein
- General indigestion, heartburn, and acid reflux
- The presence of undigested food in stool
- A desire to eat when not hungry
- Iron-deficiency anemia
- Bad breath
- Diarrhea
- Fatigue
On a final note, it’s important to know that H. pylori infections are communicable. Therefore, if you have a patient with a confirmed infection, it is advisable to test their entire household.
How to Treat Heartburn and GI Patients Efficiently and Effectively
The traditional model of treating heartburn patients with antacids and acid blockers is flawed because it does not take into account that low stomach acid, especially from H. pylori infections, is just as likely to be the cause as too much acid.
The risk of oversimplifying digestive and other health issues is that we will be holding our patients hostage in their suboptimal health when we could be enabling and empowering them to take control of their health. We must move toward a more holistic model and broaden our thinking if we are to serve our patients well.
When you join my online course, Gastrointestinal Clinical Strategies and Treatment Applications, you’ll gain the necessary knowledge to treat GI patients effectively and efficiently. This groundbreaking course is based on my 20+ years of experience working with patients, breakthrough scientific research, and time-tested clinical strategies that I’ve used in my own practice with enormous success.
By the end of this course, you’ll have a time-tested clinical model you can immediately use to help your current patients quickly return to optimal GI health.
I’ll show you a step-by-step approach to diagnosing the underlying mechanisms of gastrointestinal dysfunction and developing customized treatment strategies that work.
By the end of this course, you’ll have a time-tested clinical model you can immediately use to help your current patients quickly return to optimal GI health. Click here to learn more and sign up today.
