Friday, February 6, 2009

More Thoughts on Hydrogen Gas and Bacterial Overgrowth

It's probably not a coincidence that H. pylori lowers stomach acidity. It's trying to feed itself. Lowering stomach acidity promotes poor digestion and extra food for hydrogen gas (H2)- producing bacteria further down the digestive tract. H. pylori thrives on the resulting increase in H2. There are countless examples in nature of parasites manipulating hosts to get what they want. A pretty simple example is Bordetella pertussis, the bacterium that causes whooping cough. It secretes factors that irritate the trachea, causing the victim to cough and thus facilitating its own spread through airborne droplets.

H2 is a high-energy molecule. In fact, it's being considered as an automobile fuel. It's also very small, allowing it to diffuse away from the digestive tract and throughout the tissues. Overproducing H2 in the digestive tract creates an all-you-can-eat buffet for whatever bacteria are present in the body that are capable of using it. As I mentioned in the last post, these bacteria include H. pylori, Salmonella and perhaps Clostridium. Nature abhors a vacuum. I'm sure there are organisms happy to siphon off some of this fuel. The interior of the body is relatively sterile, but there are plenty of bacteria hanging around the mucous membranes (nasal cavity, digestive tract, urogenital tracts) that could potentially exploit this energy source.

How do we thwart H. pylori and take back control of our stomachs? There are a few options. The first is to send in the big guns and take antibiotics. This is the standard treatment and it's usually effective, but I'm generally against antibiotics unless absolutely necessary due to their long-term effects on beneficial gut flora. Then there are other treatments like mastic gum, peppermint, gentian and probiotics, which may or may not be effective.

But the method I like best is starvation (of H. pylori). Obviously, the first step is to eliminate excess fructose, wheat, and anything else that causes digestive upset and gas. Several commenters on the last post mentioned that eating a "paleolithic"-type diet improved their digestion and reduced gas. That makes perfect sense to me, and it may actually be a very important effect of that type of diet. The same goes for low-carbohydrate diets. Two other weapons of intestinal flora starvation are chewing thoroughly and avoiding liquids during meals. The former allows you to absorb the maximum amount of calories from your food as rapidly as possible, leaving less for the bacteria. The latter makes digestion more effective by keeping stomach acid concentrated. A little bit of liquid such as a small glass of wine is probably fine.

If necessary, the next step may be to restore full stomach acidity, further cutting off the supply of H2 to H. pylori and breaking the cycle of reduced acidity, leading to increased H2, leading back to increased H. pylori growth. Sufficient stomach acid may also inhibit H. pylori directly, but there isn't much research on this. Restoring stomach acidity is pretty easy to do using betaine HCl supplements. Many people report improved digestion when they use betaine HCl. These basically release hydrochloric acid into the stomach, lowering pH. Most of them also contain pepsin, a protein-digesting enzyme secreted by the stomach. Buy them in capsule form rather than tablets so they dissolve rapidly.

Ideally, you should have your stomach pH checked to confirm you have insufficient stomach acidity before taking betaine HCl. If it's not lacking, there's no point in taking it (although trying it won't do you any harm beyond a little discomfort). But if you want to skip the expense, there are web pages that can teach you how to use subjective measures to determine if it's helpful for you. Some people feel that the stomach eventually "learns" to produce enough HCl again after a course of betaine HCl, after which they can stop taking it. This may reflect a suppression of H. pylori.

I think it's notable that healthy traditional cultures that ate plant foods didn't do it haphazardly. First of all, they typically ate the minimum amount of fiber necessary to get their calories. If they could remove fiber from their food, they did. For example, ogi is a widespread grain porridge eaten in Western Africa. To make it, you soak millet, corn or sorghum overnight. Then you pound it, mix it with water and strain it through a sieve. This removes the bran but allows most of the suspended starch through. The bran is fed to the animals, while the starch is fermented, cooked and eaten.

This is typical of healthy non-industrial cultures. They don't care about the glycemic index of starches, they care about maximizing digestibility and assimilation. In the process, they are minimizing food for their digestive flora. Fermenting grains before cooking may also reduce the amount of food left for gut bacteria. Starchy tubers and fruit (plantain, breadfruit) are also common features of healthy traditional cultures. They cook them thoroughly, sometimes mash them, and sometimes ferment them as well (e.g., poi).

Low-calorie vegetables are not staple foods in most of the world's healthiest non-industrial cultures, including hunter-gatherers. That's the main reason why I'm skeptical of the claim that eating immoderate quantities of vegetables is essential for health.

I do think it's worth mentioning that although they tried to minimize fiber, many (but not all) healthy non-industrial cultures nevertheless ate a lot of it and did just fine. It was inescapable for many of them. If you don't have the technology to remove rice bran, you have to eat it along with the starch. It may be just as well. Bran carries a disproportionate amount of vitamins and minerals. But it also comes along with a disproportionate share of toxins, which must be inactivated prior to eating by soaking, sprouting or fermentation. Healthy grain-based cultures knew this well, but we seem to have forgotten it in modern times.

14 comments:

Aaron Blaisdell said...

My intestinal fortitude has increased dramatically after incorporating yogurt, raw milk, raw-milk cheese, and kefir into my daily diet, as well as minimizing the grains, especially wheat which I limit to no more than 1 slice of sprouted wheat bread every 1-2 days.

This is on top of the high-vitamin cod liver oil, high-vitamin butter oil, and 4k IU of D3 I take daily.

My stomach has never felt better or been quieter. Gut quiescence is a blessing!

Sue said...

Have you heard of the simple test to check whether you have too much or not enough stomach acid:

HAVE LEMON JUICE OR CIDER VINEGAR ON HAND:

When you have the pain; swallow a tablespoon of lemon juice or cider vinegar. If this provides pain relief, you most likely have too little stomach acid. If it worsens your symptoms; it is more likely that you have an acidic stomach.

Senta said...

This describes a method to tell if HCL/pepsin or digestive enzymes are needed. It can be used during a meal to adjust the dose. It involves pressing on reflex points one inch below the sternum and to the left and right of that point. It really works.

An Easy Way to Evaluate Digestion

Lisa said...

Stephan,

Would you be willing to post (or point me to) some of your typical days' menus? I looked at all your posts tagged 'Real Food' but I haven't seen what you eat on a particular day, i.e., breakfast, lunch, dinner, (snack?). Thanks much. Your blog is my favorite.

Lisa

Jenny said...

I think it is essential that people remember that their own specific ethnic background can point them towards the foods that their bodies have evolved to do best with.

If you are descended from herders, you may do very well on fermented milk products.

If you are descended from people who ate high fiber diets, they may help you.

Both these diets harm people who did not evolve to maintain the enzymes needed to digest them.

Dietary studies that assume everyone has the same needs ignore the very strong evidence that available diet exerts a rapid selective effect on our bodies. The presence or lack of a gene that produces lactase in adulthood is a very good example of this.

Aaron Blaisdell said...

Jenny,
I agree. I probably should have stated my ethnicity when detailing the diet that has been beneficial for me. I'm of Lithuanian and Ukrainian Jewish descent on my mother's side, and English-German descent on my father's side. As far as I'm aware, all of my family tolerate dairy very well. We seem to tolerate grains, including wheat, too, but nevertheless I've drastically reduced wheat consumption. When I do consume wheat, it is primarily sprouted.

Anna said...

Aaron,

Very clever lab rat and lever design on your website!

Aaron Blaisdell said...

Anna. Thanks. The opening flash animation was the work of a clever undergraduate working in my lab.

Now if I could only get nutritious rat chow to feed my rats, I bet their cognition would be off the charts!

Bryan said...

Somewhat stretching the topic, do you think dandruff could be related to diet? I know it is sometimes fungal, and sometimes dry skin.

Senta said...

Bryan, I think dandruff could be directly related to diet for a number of reasons. The fungal connection you mention (dysbiosis leading to yeast/fungal infection) as well as things that contribute to hyperkeratinization, like deficiencies in Omega 3 fatty acids or certain vitamins, especially A and B12.

I did not suffer from dandruff but an amazing thing I noticed once I had fully adopted a Paleo/NT low-carb type of diet was that I no longer got callouses on my feet.

Stephan said...

Sue,

Are you sure vinegar would do it? Lemon juice is close to stomach pH but vinegar is only about 1/10 as acidic.

Hi Lisa,

I haven't posted typical meals, maybe I'll do that at some point. My diet is not perfect as I share food with several other people. But I try to keep it as good as possible.

Bryan,

I think a good diet can have a major effect on the skin, probably including the scalp. But I haven't looked into that specifically.

Robert M. said...

Ethnicity is largely breaking down, especially in North America. As such I don't think trying to eat one's ethnicity is helpful, at least for younger people. I have the following ancestry in proportions greater than 10 %:

English
Norwegian
Scottish
French
Italian
Romanian
Polish

If we break these down into ethnic groupings:

Celtic
Frank
Latin
Nordic
Baltic
Slav

There are some radically different diets in the above list, and yet I'm entirely Caucasian. My grandparents could eat their ethnic diet, maybe. Consider also that China has something like 30+ ethnic groups.

Melissa said...

I've had lots of trouble with poor stomach acidity in the past even though I didn't test positive for h.pylori. I think there are other bacteria that affect it as well. The standard treatment, proton pump inhibitors, are the worst thing! They reduce acid even further, probably allowing even more bacterial growth. I developed chronic salmonella while on them and that's not something you usually see in a 20 year old.

To get rid of the problem I used a paleo diet and apple cider vinegar. I bet it was the former that did the trick. It came back again recently after I was traveling, I suspect because of the ibuprofen I took and the large amount of sugar I consumed daily. It's too bad because I had it under control for over two years and that allowed me some leeway to eat things like cake occasionally.

deanna said...

My daughter recently fell seriously ill due to sorbitol poisoning from chewing gum. We didn't know what was causing her so much pain and actually thought she might die. She suffered terrible GI pain, largely from hydrogen gas we now know,and went thru many tests, 5 Drs., ER visit, etc.. Please tell everyone to avoid sorbitol. I'd like to know what it really does in the gut and how to now eliminate my daughter's excess hydrogen gas in her gut. She still vomits in the morning while burping. I suspect this will dissipate over time. Thank you!