Marcus Ettinger BSc, DC – H. pylori treatment – H. pylori protocol.
Disclaimer: This post is not a substitute for medical advise or treatment and is for informational purposes only. Please consult with a physician before starting any nutritional protocol on your own.
H. pylori – Resources and Links
“Heartburn, chronic active gastritis, GERD, acid reflux, achlorhydria or H. Pylori - that is the question.” William Shakespeare. Are any of these conditions actually due to too much stomach acid (hyperchlorhydria)? Not necessarily. I have to admit here, I experienced a severe bout of gastritis – once, when I started-up my first practice. And yes, it hurt. It felt exactly like someone poured a quart of battery acid down my throat, at the same time I was having a heart attack, while licking a brand-new nine volt battery. I think you get the picture. (The Digestive System)
Well, to make a long story short, my stress wasn’t going to go away in the next five minutes, so I needed to apply my “medical detectiveness” and back-track the pathophysiology of the condition, to figure out the cause. Knowing the cause and predisposing factors would allow me to apply the precise heartburn treatment, H. pylori treatment, chronic active gastritis treatment, GERD treatment or low stomach HCl treatment. The cause and predisposing factors were:
My Predisposing Factors:
1. Chronic Dehydration – There are different types of mucous cells in the stomach and they are easy sources to supply the body with water when dehydrated. The thinning of the gastric mucosa or destruction of that mucous membrane layer, makes the stomach vulnerable to acids – hydrochloric or those produced from fermentation of ingested sugars and purification of ingested proteins. Decreased stomach acid (HCl) also creates the perfect storm for the introduction and/or colonization of the dreaded H. pylori bacterium.
2. Zinc deficiency - I picked-up on this during a hair-mineral analysis. Zinc deficiency as a single factor would, most likely, not cause anything overtly noticeable. When combined with a Helicobacter pylori (H. pylori) infection, the compounding effects created a more severe inflammatory reaction within the gastric lining.
3. Wine and Beer - Ethanol on its own can create painful erosion and inflammation of the gastric lining, but when combined with the zinc deficiency, it can compound the degree of inflammation and drastically delay healing.
4. H. pylori or Lack of HCl? – After testing it was confirmed the H. pylori was present. Now was my lack of HCl the reason I got the H. pylori or was the H. pylori the cause of the reduced stomach acid?
So, at this point, not only was I up shit-creek without a paddle, I was missing the canoe too.
So What Was the True Cause of My Gastritis?
#1, #2, #3 and #4 all played their individual parts in my condition. A little more on #4 – Achlorhydria (lack of stomach HCl) or H. pylori bacteria: This is the, what came first, chicken or the egg dilemma. Did my lack of stomach acid allow the H. pylori a safe haven to take up residence OR did the H. pylori infection cause the lack of stomach acid? Both are possible and both allow the other to exist, and create a painful condition called atrophic gastritis. This is exactly what I had, and, I am sure, a little erosive gastritis as well.
H. pylori bacteria
Diagnostic Testing:
After some diagnostic testing: allopathic (traditional medicine), which included BioHealth Diagnostics Laboratories 401H ( GI Pathogen Screen w/ H. pylori Antigen $270.00) and energetic testing (Applied Kinesiology & Contact Reflex Analysis), I now knew what was going on, what caused it and what to do to get it completely under control. I confirmed that I did have Helicobacter pylori - H. pylori for short.
The True Cause – H. pylori:
Helicobacter pylori (H. pylori) is a spiral-shaped gram-negative bacterium which was identified in 1979[1]. It produces urease in abundance, the activity of which, through the production of ammonia, together with the bacterium’s motility and ability to adhere to the gastric mucosa, enables its survival in the acid environment of the stomach. About half of the worlds population house H. pylori, in their stomach, and are unphased by it. But in about 15 percent of those infected, the microbes cause peptic ulcers and chronic active gastritis, and in an unluckier bunch the H. pylori is a causative agent for gastric cancer and mucosa associated lymphoid tissue lymphoma[2]. It has also been shown to be associated with extragastric diseases, such as iron deficiency anemia and idiopathic thrombocytopenic purpura[3-5].
1. Pajares JM, Gisbert JP. Helicobacter pylori: its discovery and relevance for medicine. Rev Esp Enferm Dig 2006; 98: 770-785
2. Sari YS, Sander E, Erkan E, Tunali V. Endoscopic diagnoses and CLO test results in 9239 cases, prevalence of Helicobacter pylori in Istanbul, Turkey. J Gastroenterol Hepatol 2007; 22:1706-1711
3. Bohr UR, Annibale B, Franceschi F, Roccarina D, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection — other Helicobacters. Helicobacter 2007; 12 Suppl 1: 45-53
4. Franceschi F, Roccarina D, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection. Minerva Med 2006;97: 39-45
5. Franceschi F, Gasbarrini A. Helicobacter pylori and extragastric diseases. Best Pract Res Clin Gastroenterol 2007; 21: 325-334
My H. pylori Treatment Protocol
Pre-treatment – First, I took antacids (over the counter – Zantac OTC) to increase the susceptibility of the H. pylori to treatment/eradication (lesson the need of H. pylori to defend itself so vigorously) and allow my gastric mucosa a chance to heal. Note: The H. pylori form protective bacterial colonies called biofilm, which are made up of a protective, extracellular polysaccharide shield. This protective shield is a defensive barrier against stomach hydrochloric acid and other factors, like antibiotics. Being a complex matrix of proteins and carbohydrates, which are probably interdependent, the H. pylori biofilm could possibly offer a protective haven for the survival of this gastric bacterial pathogen in the extragastric environments (Proteomannans in Biofilm of Helicobacter pylori ATCC 43504).
Treatment – Second, my personal H. pylori bomb consisted of: x,xxx mg’s 2x/day of Monolaurin (xxx mg’s lauric acid per cap – also see coconut oil, which is 50% lauric acid by weight) and x caps x times per day of H-PLR (Supports bacterial elimination) from Apex Energetics. I also juiced 1/4 cabbage every day (cabbage contains S-Methylmethionine also known as Vitamin U, a great healer of ulcers and gastritis). After 4 weeks on my protocol I was feeling like a new man! I rechecked myself, after 8 weeks, and was free of the foreign invaders, breath test confirmed the same.
Note: As of September 2009, I’m also adding Klaire Labs – InterFase Plus, x caps x per day on an empty stomach to my H. pylori treatment protocol. InterFase Plus is now an important and mandatory part of the protocol. InterFase Plus aids in the eradication of biofilm, especially H. pylori biofilm colonies. This is a major advancement in my protocol. Understanding BIOFILM is extremely important for a variety of reasons. Please follow any biofilm link to read more about it and also see my biofilm protocol. Additional products taken during the treatment phase: Probiotic Defense Powder (multi-strain pro-biotic and pre-biotic formula), NAC by Now Foods and Psyllium Husk Fiber.
Certain dietary restrictions and additions will need to be taken. These are determined on a case by case basis.
Prevention – Third, was to keep the H. pylori bacteria from coming back and keep the healing process moving forward. I took digestive enzymes w/HCl* – x w/ea. meal, plant based enzymes – x w/ea. meal, zinc** – xx mg’s x per day, L-carnosine** – xxx mg’s x times per day, mastic gum*** x,xxx mg’s x times per day, TheraAloe**** – x ounce x times per day, chlorophyll – xxx mg’s x per day (chlorella or spirulina can be substituted for chlorophyll), a daily broad-spectrum probiotic (Probiotic Defense Powder or Probiotic-10 from Now Foods), psyllium husk fiber (x heaping Tbsp x-x times per day) and tons of distilled water, for 6 weeks. I was now better than before my first symptom.
All-in-all, it was a learning experience, and one that has made me a better doctor and a more diligent medical detective.
FYI: Gastritis is not a single condition, but several different conditions that all share inflammation of the stomach lining as a common symptom. Gastritis, most often, is caused by prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin, drinking too much alcohol or infection such as Helicobacter pylori bacteria (H. pylori). It may also occur after a major surgery, severe infections, trauma-injury-burns, or severe infections. Some diseases, such as pernicious (B12 deficiency) anemia, autoimmune diseases, and chronic bile reflux, can cause gastritis as well.
*Microscopy studies of the motility of H. pylori in gastric mucin at acidic and neutral pH in the absence of urea show that the bacteria swim freely at high (alkaline – achlorhydria) pH, and are strongly constrained at low (acidic) pH. Also, H. Pylori, through enzyme reactions promote increased ammonia production, which raises the pH of its environment – allowing it to move more freely.
(**)A combination of zinc and L-carnosine has been shown to prevent gross visible damage to gastric mucosa caused by ethanol ingestion. This combination also acts as a potent antioxidant, specifically benefiting the gastric mucosa.
***There is conflicting data on whether mastic gum kills H. pylori effectively in vivo (live human trials). Killing it in a test tube or mice is one thing, but I am interested in living human beings. There is evidence that it aids in the healing of the gastric mucosa, possessing anti-inflammatory properties. I used it for healing rather than as an agent to kill the H. pylori bacteria. Note: there are studies that have shown that mastic gum kills H. pylori. The problem is that it is in less than 30% of the trial groups. So it works in about 1 out of every 3 that try it as a primary treatment (at dosages of 500mg’s 3x/day).
****TherAloe is a high molecular weight polysaccharides containing aloe vera juice product. Its healing capabilities, as far as I am concerned, are quite profound on the gastric mucosa.
Important Note on Purchasing Products:
All dosages will be provided if you purchase some or all of your products through my office. I truly do want to help all who are interested, but it’s finally gotten to the point where too many people want free advice and an increasing amount of my time, and then buy all of their products elsewhere. I am a firm believer in fair exchange and I feel I have done that by providing the information in this post.
I also offer tailor made protocols for your individual situation, please contact our office for product prices and distance patient information (714) 639-4360
H. Pylori Articles:
Updates:
September 13, 2009 Update – I am now taking, Source Naturals – Broccoli Sprouts Extract, which provides 2,000mcg’s sulforaphane daily. This is equivalent to eating more than a pound of fresh broccoli. Dietary Sulforaphane-Rich Broccoli Sprouts Reduce Colonization and Attenuate Gastritis in Helicobacter pylori–Infected Mice and Humans
October 03, 2009 Update - H. pylori most likely will live in biofilm colonies which make them even harder to kill or be identified by our host defenses. Read more about biofilms here and my protocol to remove them. BIOFILMS
November 03, 2009 Update – In my never ending quest for knowledge, I just came across this interesting piece of data. The H. pylori bacteria is thought to have been with us for around 58,000 years and migrated with modern man out of east Africa. Here is the link to this article. – An African origin for the intimate association between humans and Helicobacter pylori
November 18, 2009 Update – Here are two PubMed articles validating the effectiveness of Monolaurin for the prevention and/or eradication of H. pylori.
Int J Antimicrob Agents. 2002 Oct;20(4):258-62
Bactericidal effects of fatty acids and monoglycerides (Monolaurin) on Helicobacter pylori
Bergsson G, Steingrímsson O, Thormar H. Institute of Biology, University of Iceland, Grensasvegur 12, 108, Reykjavik, Iceland. bergsson@here.is
The susceptibility of Salmonella spp., Escherichia coli and Helicobacter pylori to fatty acids and monoglycerides was studied. None of the lipids showed significant antibacterial activity against Salmonella spp. and E. coli but eight of 12 lipids tested showed high activity against H. pylori; monocaprin and monolaurin being the most active. The high activity of monoglycerides against H. pylori suggests that they may be useful as active ingredients in pharmaceutical formulations.
Mol Cell Biochem. 2005 Apr;272(1-2):29-34
Minimum inhibitory concentrations of herbal essential oils and monolaurin for gram-positive and gram-negative bacteria
Preuss HG, Echard B, Enig M, Brook I, Elliott TB. Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC 20057, USA. preusshg@georgetown.edu
New, safe antimicrobial agents are needed to prevent and overcome severe bacterial, viral, and fungal infections. Based on our previous experience and that of others, we postulated that herbal essential oils, such as those of origanum, and monolaurin offer such possibilities. We examined in vitro the cidal (def. killing, as in bactericidal) and/or static effects of oil of origanum, several other essential oils, and monolaurin on Staphylococcus aureus, Bacillus anthracis Sterne, Escherichia coli, Klebsiella pneumoniae, Helicobacter pylori, and Mycobacterium terrae. Origanum proved cidal to all tested organisms with the exception of B. anthracis Sterne in which it was static. Monolaurin was cidal to S. aureus and M. terrae but not to E. coli and K. pneumoniae. Unlike the other two gram-negative organisms, H. pylori were extremely sensitive to monolaurin. Similar to origanum, monolaurin was static to B. anthracis Sterne. Because of their longstanding safety record, origanum and/or monolaurin, alone or combined with antibiotics, might prove useful in the prevention and treatment of severe bacterial infections, especially those that are difficult to treat and/or are antibiotic resistant (also see biofilm, as a source of antibiotic resistance).
Note: Monolaurin has been shown to inactive many forms of bacteria and virus’ that are protected by an outer lipid membrane, known as an envelope (H. pylori cell envelope). The mechanism is due to monolaurin’s ability aid in the disintegration of this lipid membrane.
May 02, 2010 Update - A recent review, just published, of available literature on the use of probiotics in the treatment or prevention of H. pylori infection, validated that, “Both in vitro and in vivo studies provide evidence that probiotics may represent a novel approach to the management of H. pylori infection.”
Helicobacter. 2010 Apr;15(2):79-87.
Role of probiotics in pediatric patients with Helicobacter pylori infection: a comprehensive review of the literature.
Lionetti E, Indrio F, Pavone L, Borrelli G, Cavallo L, Francavilla R. Department of Paediatrics, University of Catania, Catania, Italy. elenalionetti@inwind.it
March 28, 1011 Update – Helicobacter pylori infection has been associated with diverse extra-digestive morbidity, including insulin resistance (IR) syndrome (1), atherosclerosis and cardiovascular diseases (2). Insulin resistance is the pathophysiologic background of the clinical features of atherosclerosis and cardiovascular diseases.
Morbidity – The rate of incidence of a disease. (Medicine / Pathology) Also called morbidity rate the relative incidence of a particular disease in a specific locality.
1. Gunji T. Helicobacter pylori infection significantly increases insulin resistance in the asymptomatic Japanese population. Helicobacter. 2009 Oct;14(5):144-50.
2. Polyzos SA. The Association Between Helicobacter pylori Infection and Insulin Resistance: A Systematic Review. Helicobacter. 2011 Apr;16(2):79-88. doi: 10.1111/j.1523-5378.2011.00822.x.
Tags: Atherosclerosis, Biofilm, Cardiovascular Diseases, Cell Envelope, Coconut Oil, Enveloped Virus, Gastritis, GERD, H. pylori, Heartburn, Insulin Resistance, Lauric Acid, Monolaurin, Sulforaphane
Gloria,
It is very important that you read all my posts on biofilm (Biofilm Protocol). This is the reason why infections (sinus, gut…) go chronic and why antibiotics are not effective in getting rid of them. A gluten free diet will help make everything you do healing-wise, easier. I like moderate exercise for stress relief. Anxiety is a result of when you feel that things are out of your control. Get educated on biofilm, surround yourself with supportive people, eat a natural diet and get in regular sleep and exercise. I hope this is of some help to you. Please update me on how thing go.
Sincerely,
Dr. E
After 4 months with 2 antibiotics for 7 days I have done now a stomach biopsy and a breath test.
Breath Test: Positive for Helicobacter
Stomach Biopsy: Negative for Helicobacter, not found.
Now I continue to have light stomach pain only after lunch and another 3 weeks before new consult with my new physician. Very confused and dissapointed with my situation after months
I suppose biopsy is more reliable than breath test.
Hello Dr. Ettinger,
I too have H. pylori (diagnosed last November). I’ve been on two antibiotic treatments, one Prevpak which I didn’t finish and recently Pylera for 10 days. I also have gastritis. I was feeling fine after I finished but the gastritis came back which leads me to believe that I still have the H. pylori. I also lost 28 lbs. I’m down to 100 lbs which I can’t afford to lose. In between the antibiotics I was working with an herbalist here locally. He put me on chlorophyll and a powder of slippery elm, DGL and cuttlefish twice/day. In addition I took mastic gum, Pine nut oil and regular supplements (probiotic, D3, B12, multi etc.). This did not eradicate my H. pylori. He said I had low stomach acid and taking this stuff would heal my stomach lining and the H. pylori would die. In addition to the above I am drinking a lot of cabbage juice and have added oil of oregano to my routine.
I will give another stool test next week and should have the results in two weeks when I see my GI doc first week in Dec. Question – is it possible to have a negative result if I still have gastritis? I’ve been reading all your posts and willing to follow your regiment especially because you went through it. What do you recommend that I haven’t mention above? Do you do private consultation (by phone or email)?
Many thanks.
Maria,
Yes, it is possible to still have gastritis and a negative test. My recommendation is to have a new stool test and then we can rule-in or out H.pylori as the cause. At that point it will be a lot easier to nail-down the cause and handle it. I will forward you a distance patient form. Please get in touch with me when you get your test results.
Dr. E
Dr. E
Can I continue taking the supplements I mentioned earlier right up to when I give my stool test or do I have to quit? With antibiotics I have to wait 2 months before testing. Maria
Maria,
Supplements are fine, as long as they are not anti-parasitic. If you are taking any anti-fungal, bacterial or parasitic medications, you will have to wait.
Dr. E
Dr. Ettinger,
Your website, along with Amy King’s, has been so helpful in giving me a natural alternative to getting rid of H. pylori. I’ve been very sick, mostly all undiagnosed by multiple doctors, for over 4 years! I’m hoping being free from H. pylori will help many of my symptoms. I am on a protocol twice a day of 4 different biofilm busters, 4 different anti-bacterials, and a few different “clean-up” methods. Plus, other helpful supplements, probiotics, etc for gut healing.
Two questions:
1) I have Mitral Valve Prolapse and the frightening heart palpitations, light-headedness, difficulty breathing, and low level anxiety that goes along with it. Since starting the protocol it’s getting a lot worse. I fear not taking Magnesium (due to the biofilm) is really taking a toll on my heart. Would it be too detrimental to add it back? Any other recommendation for the MVP while doing the protocol?
2) I’m currently using activated charcoal, apple pectin, psyllium husks, and spirulina for the “clean-up”. I’m concerned (not sure of the long term effects) about taking charcoal daily for 6-8 weeks. Should I be?
Thank you for your time and any advice you may have!
Marcella,
Take the magnesium at least 3-4 hours, before or after, the biofilm “busting” supplements.
I am not a big fan of activated charcoal as a dietary supplement. I would take a heaping tablespoon of the spirulina instead. NAC is a good product too.
Dr. Marcus Ettinger
One year after removing Helicobacter, gastritis symptoms return. I suppose I will have to do another Helicobacter test and/or and endoscopy. Gastritis sucks…stomach and chest pain. I have returned to supplements I used last year, I have noted that I have real relief after taking natural butter (ghee maybe is a better option). In zen medicine I have found some basis to this relief on stomach problem with butter
I just found your website and I am hoping you can help me. We travel the world as a lifestyle so that complicates things, but we are in California for a few months now.
http://www.soultravelers3.com/2011/09/travel-health-secrets-for-long-term-digital-nomads.html#more
I have had severe digestive problems since last May ( a year and half ago) and a very distended upper stomach since last February when it kicked up into even higher gear. I have gotten relief with acupuncture, TCM herbs and tried many of the products you mention ( but not in your order or all of them).It comes and goes in severity but some swelling and discomfort has been constant, some days or middle of the nights …emergency room level distress.
Can you tell me what your rate of long term success has been with your protocal? I do not want to take the antibiotics ( I have had candida in the past and respond much better to alternative methods) but have wasted a ton of time and money on finding a cure for me, that I am too desperate now to waste any more time. I need success now and am willing to do what that takes.
I spend all day, every day on trying to feel better and still remain up and down, usually more down than up. I need to get out of survival mode. I spend 2 to 3 hours or more every day doing saunas and hot tubs with jets on back ( back of distressed stomach area) between cold pool swims as that usually gives me some relief from the severe toxic feeling. ( Doing this daily since Feb).
I hope you can help me as everyone says the only cure for hpylori is antibiotics, but I am pretty sure the allopath way will make me sicker.
My success with my H. pylori protocol is 100%. That said, it doesn’t mean that if we eliminate the H.pylori your symptoms will disappear. Only if H. pylori is the only factor will you have complete relief when it’s gone. If you are anywhere south of Santa Barbara and North of Baja California, it would be best to come in and see me. You may also call me at 714-639-4360 for distance help. I look forward to hearing from you.
Hi Dr. Ettinger,
You mentioned that you went on a pre-treatment with antacids to heal your GERD/Gastritis symptoms before going on the H. Pylori protocol with Interfase Plus, and other supplements. How long would you advise going on antacids before attempting your protocol? I’m afraid to go on prilosec considering it may make my H. Pylori worse; yet, I need to heal from gerd/gastritis symptoms. I believe I may have low stomach acid as well. Any suggestions?
Marie,
I can’t make a recommendation on how long you should take an antacid. The Prilosec will not make the H. pylori worse and is taken during the eradication phase. Most people over the age of 40 have diminished capacity to produce adequate HCl in the stomach. I take a digestive enzyme containing HCl with all of my meals.
I hope this helps.
Dr. Ettinger
Dear Dr. Ettinger,
Your blog about H pylori has been of great help. I have had mild to moderate gastritis (as evidenced by recent endoscopy) for the last one month or so. My biopsy revealed a small number of H pylori organisms but no ulcer or erosion. I was on Zantac (150mg) for about a month and a half before I went for endoscopy. Now my GI doc has recommended triple therapy. My gastritis symptoms have disappeared about 50-60% than earlier. I want to try treating H pylori naturally since I am worried about the side effects of the antibiotic. I have started eating Virgin Coconut oil 2-3 tsp a day for the past 2-3 days and I’m going to order some manuka honey online. Do you recommend any particular brand? Also, are there any side effects of Manuka honey? Is mastic gum safe since I have read some forums where people experienced gastroparesis as a result of taking mastic. Please advise. I am willing to call for consultation since I live on the east coast.
Thanks in advance!
Parag,
EVCO is okay at 2tsp/day as is the Manuka honey and mastic gum. This issue with the three is that they are weak as far as treatments go. I do not carry those products in my practice or make recommendations on them because of their lack of efficacy. The protocol I have put together is very effective and I have pre and post tests to that fact. If someone wants to take the above three in addition, all the better.
I do offer distance patient consultations. The majority of H. pylori patients I help are helped this way. Please follow this link for the data. I can also be reached if you have questions on the distance patient consulting at 714-639-4360
Sincerely,
Dr. Ettinger