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Helicobacter pylori – the bacteria that may have met its match

Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide, colonising the gastrointestinal tract of more than 50% of the global population.1 A highly adapted, spiral shaped, gram negative bacteria,2 H. pylori can persist in the stomach of an infected person for their entire life and, in about 70% of cases, be completely asymptomatic.1,3 Unfortunately this persistence triggers gastric inflammation and damage to the mucosal barrier which, in turn, leads to the development of various gastric disorders ranging from mild discomfort including reflux and heartburn, to more serious conditions such as peptic and duodenal ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric adenocarcinoma (the third most common cause of cancer-related deaths worldwide).4-6

Although the majority of the human population is colonised by H. pylori, only about 10–20% are likely to develop peptic ulcer, and only 1–2% are at risk for gastric cancer.3 Many factors are known to influence an individual’s risk of gastrointestinal disease, with most emphasis to date focusing on bacterial virulence factors, and environmental factors, particularly diet (see figure 1). However, a potentially significant determinant of the outcome of H. pylori infection that is gaining traction is the composition of the host gut microbiota and the use of probiotics.7,8

In addition to the recent identification of the importance of our microbiome, the 1982 research by Australian scientists Barry Marshall and Robin Warren, also linked escalating H. pylori to low stomach acid.

The Medical Approach

Classical first-line treatment of patients diagnosed with H. pylori infection involves the use of triple therapy (which consists of concomitant prescription of two antibiotics and a proton pump inhibitor – ant-acid). Quadruple therapy (i.e. concomitant prescription of three antibiotics and a proton-pump inhibitor) remains the best second-choice treatment. However, H. pylori eradication rates following this standard regime are generally poor due to antimicrobial resistance and patient non-compliance.4,9

Influence of H. pylori on the gut microbiota

The gut microbiota plays an integral role in numerous physiological and metabolic processes, and the delicate balance within which our microbiota exist determines states of health or disease.10,11 The introduction of H. pylori to the stomach may lead to disease indirectly by disrupting this balance of beneficial organisms.

Recent studies have revealed significant differences between the microbiota of individuals with and without H. pylori infection.12 Overall, H. pylori-negative individuals harbor a microbiota that is more complex and highly diverse compared to H. pylori-positive individuals. In H. pylori-negative individuals, the most abundant phyla are typically Firmicutes, Actinobacteria and Bacteroidetes. Following infection with H. pylori, Proteobacteria (and specifically H. pylori) dominate the gastric microbiota.1 

It is suggested that Proteobacteria (such as H. pylori) may represent a “microbial signature” of disease, as they are often overrepresented in several intestinal and extra-intestinal diseases, mostly with an inflammatory phenotype. Examples of disorders in which Proteobacteria are implicated include IBD, obesity, diabetes, asthma, COPD and NASH/NAFL.13

Probiotics are emerging as an effective adjunct and, at times, alternative to antibiotics in the treatment of gastrointestinal infections such as H. pylori. Mechanisms via which probiotic bacteria can inhibit H. pylori include both immunological and non-immunological means.14

 The Natural Approach

Although great advances have been made in understanding the complex interplay between the gastric microbiota, probiotics and H. pylori in the development of gastric inflammation and disease, herbal medicine can play a fundamental part of any H. pylori treatment protocol. An increasing number of studies suggest that H. pylori infection can be suppressed through the use of medicinal plants, with the benefit of less adverse side effects than conventional treatments.19,20

In addition to their anti-microbial activity, medicinal herbs also impart broader benefits via their antioxidant, anti-inflammatory, immunomodulatory and gastro-protective properties4 enabling natural healthcare practitioners, to treat the person and not just the disease.

Addressing the variants in why H. pylori is able to proliferate and cause gastric damage and perhaps even more complicated health conditions, is how True Medicine approaches this health condition.  Assessing stomach acid levels, overall gut health, stress levels and diet, may help determine a more successful whole-of-body approach to remedying the imbalance which has enabled H. pylori to take over and cause possibly serious problems.

If you are experiencing any digesting or health concerns, call True Medicine on 0468 774 633 for an appointment.

Article courtesy of Integria Healthcare, written by Narelle Cook.

References – not published but available on request.