If you have any sort of digestive problem—for example gas, bloating, inflammatory bowel disease (IBD), acid reflux, ulcers etc.—you’re probably wondering, why me? What’s causing me to suffer with bad indigestion or abdominal pain?

Some healthcare providers oversimplify the answer to that question. They try to blame all your digestive problems on one organism. For example, if you have acid reflux or ulcers, then Helicobacter pylori (H. pylori) must be the only organism to blame, right? 


First of all, organisms like H. pylori, despite what you may have heard, aren’t always bad. Sometimes, they can actually benefit your health. 

It’s actually when H. pylori gets together with its friend Candida albicans that it causes the most trouble. 

Organisms that team up like this with other organisms may be called synergists or co-infections. 

What does that mean for your digestive health? It means that if you’ve got two different potential troublemakers (certain bacteria or fungi) living in your GI tract, it might spell more trouble than if you only had one. 

But it’s more complicated than that. Remember, most of the organisms or “good bugs” living in your gut are helpful or harmless. Scientists call them commensal bacteria. On the other hand, there is a small percentage that can be harmful, or pathogens. We will call those “bad bugs.” 

The kicker is that your gut health determines whether a bad bug can cause trouble or not. For example, if you have good gut health with plenty of healthy bacteria and their beneficial byproducts, even a few different bad bugs won’t cause trouble. An unhealthy gut, on the other hand, can make your GI tract more vulnerable to even one type of bad bacteria or fungi that makes its home there.

In this blog post, I’ll use H. pylori and Candida to paint a picture of an example of commensal organisms that can turn bad. I’ll also show you how the presence of these two organisms can make or break your digestive and overall health.


What Is H. Pylori Anyway?

H. pylori is a bacterium that colonizes the lining of the stomach. Its presence is linked to duodenal and peptic ulcers, gastritis (inflammation of the stomach lining), and gastric cancer. Stool tests have also detected it in people with ongoing indigestion and abdominal pain. That’s why a lot of doctors go after H. pylori as a standard peptic ulcer or stomach ulcer treatment. 

H. pylori really gets around. In fact, as many as 50% of adults carry this bacterium at some point in their lives but most have no symptoms. 

H. pylori isn’t always a nasty bug as I will explain why later. But it can be nasty sometimes. With my clients, I will use agents that fight back an H. pylori overgrowth when any of these conditions are present:

  1.  H. pylori overgrowth on testing.
  2. The presence of virulence factors. These are harmful substances that H. pylori makes to set up a home in the gut, avoid the immune system, and cause disease. Virulence factors increase the risk that H. pylori will cause digestive upset, ulcers, or cancers.
  3. Classic H. pylori symptoms such as ulcers, gastritis, upper GI bloating, acid reflux, acne, and more. When H. pylori overgrows in the gut, it tells me there is an underlying weakness. And while I do treat certain patients for it, at the same time I am asking the question: “Why?” Why did H. pylori take root and grow out of control?

What Causes H. Pylori?

H. pylori gains a foothold in your GI tract when levels of stomach acid take a nosedive. This can be a problem because when H. pylori turns bad, it can harm cells, cause inflammation, and damage the stomach lining.  Here are some of the things that can cause low stomach acid:

  • Drinking alcohol
  • Drugs used to treat acid reflux (proton pump inhibitors)
  • H. pylori itself
  • Smoking
  • Stress


H. Pylori: Not Always The Bad Guy

But here’s the thing about H. pylori: sometimes it’s actually your friend rather than your enemy. It has been co-evolving with us for millennia. At normal levels, H. pylori can be a commensal or friendly bacteria. While it has the potential to be a pathogen, it doesn’t cause disease in many people. In fact, it can:

  • Reduce allergies, asthma, and skin diseases like eczema, especially in children.
  • Lead to a lower risk of developing IBD. It does this by making some beneficial changes to the gut microbiome, the collection of bacteria, both good and bad, that live in the intestinal tract. This is why I often don’t want to get rid of H. pylori when I’m treating patients with inflammatory bowel disease.

Really, with H. pylori, what it comes down to is how many of these little guys do you have in your GI tract? And how virulent are they (meaning how likely are they to do damage)? 

It’s also important to treat any underlying causes that made it too easy for H. pylori to set up shop.

And then there’s the question of: are you also infected with Candida?


What Is Candida?

Candida is a fungus that hangs out in nearly everyone’s intestinal tract. It’s part of the microbiome and thus a commensal fungus. In fact, Candida species appear in 40% to 80% of normal stool specimens. 

However, when Candida goes from Jekyll to Hyde it can cause vaginal yeast infections and oral thrush. What is oral thrush? That’s when Candida builds up in the mouth and causes white sores on your tongue, lining of your mouth, gums, and throat. And that’s just the beginning. In functional medicine practice, I have seen Candida cause brain fog, fatigue, skin rashes, diarrhea, constipation, gas, anal itching, and joint pain.  

Just like H. pylori, Candida can be a harmless wallflower in the gut or it can be a deadly pathogen.

What causes Candida to turn from harmless to health-harming? Here are some common reasons for Candida gone bad:

  • Eating lots of sugary and processed foods 
  • Hormonal imbalances and birth control 
  • Stress
  • Taking antibiotics, which kill off the good bacteria in your intestines
  • Untreated diabetes
  • Weak immune system


When Candida Meets H. Pylori

Candida and H. pylori are good friends. In fact, H. pylori can make itself comfy and at home inside Candida. And once Candida teams up with H. pylori, things go south quickly.  Research found that if you’re infected with both these organisms you’re more likely to develop gastric ulcers or have more severe gastric damage than if you had H. pylori alone. Pairing up Candida with H. pylori also leads to a higher risk of peptic ulcer disease, hence the name “synergists.”

A lot of people have both of these infections at the same time. For example, in one study, out of 27 people positive for Candida, 18 were also positive for H. pylori. This is why I test for the presence of both of these organisms in my patients with GI problems. 

The partnership between Candida and H. pylori is just one example of how synergistic organisms can impact your health. Candida is a real social butterfly. It has a lot of friends besides H. Pylori. These include the bacterium Clostridioides difficile (aka Clostridium difficile, the microbe responsible for bloody diarrhea). I used the friendship between Candida and H. pylori because it’s one of the best ways to show you how organisms can pair up to make your health worse. 


Is Your Gut Ready To Face the Bad Guys?

In regards to GI issues, it’s really not about the “bad guy.” It’s all about whether you can tolerate the organisms that live in your gut. Some people with H. pylori and Candida have no symptoms at all. 

The most important factor in this equation is your gut health. If H. pylori and Candida are present in excess it means you’ve got an underlying weakness in your GI tract. And we have to get at the bottom of why the weakness is there.

The answers to four questions will let you know how well your body will deal with invasions by these organisms:

  • Are the good bacteria in your gut balancing out the bad bacteria?
  • How effective is your stomach acid and digestion?
  • How strong is your gut lining?
  • How well is your immune system working?

It’s not possible to answer these questions on your own. That’s why, if you have GI problems, it’s best to work with me or another functional medicine provider to order the right testing, pinpoint the root causes, and design a customized protocol just for you. 

Your path to better gut health begins with a free 15-minute troubleshooting call. During this chat, I’ll get to know more about what troubles you. If after the call you come on board as a patient, I’ll work with you to get rid of diarrhea, constipation, abdominal pain, gas, indigestion, acid reflux, and more. Book your call today and you can say goodbye to those frustrating, painful, and embarrassing GI problems and hello to great gut health!