December 18, 2017 at 10:45 am #1014Archived PostsModerator
Suspected gastritis with immediate pain (below sternum) on eating – 49yr old female
I’d appreciate some advice on a client I am currently seeing. Presenting symptoms: diarrhoea and bloating. Comprehensive stool analysis revealed some pathogenic bacteria (Klebsiella Pneumoniae 4+PP), some yeast (Candida Albicans 2+PP), low butyrate, low total SCFAs. Ill health in the family (husband) has been very stressful (over preceding couple of years) and client is now susceptible to anxiety.
Has a busy family life with older teenagers. Less tolerance to everyday family life events. Attempts to manage with mindfulness, dog walking, general awareness of her reaction to external events. I initially recommended FOPMAP diet and Tanalbit. Client had tried kefir, probiotics and digestive enzymes but stopped taking as no noticeable improvement. She also takes L-Theanine and 5HTP (self-prescribed). Diarrhoea has ceased in the past month however, eating now frequently causes pain just below the sternum, and pain often experienced through to the back region, within few minutes of eating. Nuts, seeds, citrus fruits, bell peppers definitely trigger this pain. Can tolerate pasta and rice and most vegetables. Bread appears to ease discomfort. GP has now recommended Lansoprazole for 8 weeks for suspected gastritis. Tis has helped. I suspect low HCL is implicated (ongoing stress, and potentially resultant dysbiosis) but with suspected gastritis, I’d appreciate some support on the best way to proceed. Many thanks in advance.
Posted by Jane Bains 18.12.17
March 6, 2019 at 10:46 am #1016Christine BaileyModerator
Many thanks for your question about your client with gastritis. Ideally it would be useful if the GP could refer your client for an endoscopy to check for ulcers, hernias and of course, Helicobacter pylori.
Gastritis is an inflammation of the protective lining of the stomach. Acute gastritis involves sudden, severe inflammation. Chronic gastritis involves long-term inflammation that can last for years if it’s left untreated.
Weakness in your stomach lining allows digestive juices to damage and inflame it, causing gastritis. Having a thin or damaged stomach lining raises your risk for gastritis.
A gastrointestinal bacterial infection can also cause gastritis. The most common bacterial infection that causes it is Helicobacter pylori. It’s a bacterium that infects the lining of the stomach. The infection is usually passed from person to person, but can also be transmitted through contaminated food or water. It is important this is ruled out.
Certain conditions and activities may increase your risk for developing gastritis. Other risk factors include:
extreme alcohol consumption
routine use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin
age, because the stomach lining thins naturally with age
stress caused by severe injury, illness, or surgery
autoimmune disorders – particularly coeliac disease
digestive disorders like Crohn’s disease but it may also be that gut infections could be contributing to low grade inflammation
poor bile flow
Lee et al. The aging stomach: implications for NSAID gastropathy Gut 41 issue 4 https://tinyurl.com/y7lvhuxt
As the medication has improved her symptoms I wonder if there is ongoing inflammation in the stomach area and / or an ulcer. In which case I would avoid anything that may aggravate this – this include certain supplements like Betaine HCL, digestive enzymes and certain foods. The common foods are gluten, chili, chocolate, spices generally, coffee and caffeine drinks, tomatoes, citrus fruits but every client is different and may find other foods also make it worse and you already have mentioned a few other foods. Eating small meals rather than large meals can also be helpful and ensure at least 12-14 hours overnight of not eating – so eating earlier in the evening is better.
I note that she does have gut infection and this in itself may aggravate her symptoms. As gluten / coeliac can be linked to gastric issues then I would remove this 100% from the diet or consider Cyrex array 3 to test. The reason she may feel bread and starches appear to help is that they ‘mop’ up acid or buffer the stomach. But she can easily switch to gluten free versions. Other useful additions include Aloe vera, slippery elm and marshmallow root (mucilage herbs) in addition to supplements noted below. In view of the klebseilla, ideally, I would recommended oregano – however, at this stage it may aggravate her symptoms so priority should be to calm the inflammation down and relieve the soreness.
Stress can of course contribute to the symptoms as mentioned above so you may need to consider stress support or run an adrenal saliva test.
Olivier 2009 Helicobacter pylori bacteria: Tools for Eradication. The Original Internist June 2009 Vol. 16, No. 2 https://tinyurl.com/y8j3mv4g
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Stabilium 200 (ARG) – take 4 in the morning – https://tinyurl.com/hhz7228
Soothing and healing
Sano Gastril (ARG) – suck 1-2 around each meal or when she experiences soreness
Gastrazyme (BRC) – take 2 with each meal
Perm a Vite (ARG) – take 1 tbsp three times a day
Arthred Collagen powder (ARG) – take 1tbsp three times a day
Lactobacillus plantarum, rhamnosus and salivarius (ARG) – take 2 daily – http://tinyurl.com/z9g65f2
I hope this helps with your client
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