Patient taking the two capsules of HCl each meal for a prolonged time causes thinning of the stomach lining. This patient had H. pylori got treated by triple-antibiotic therapy 12 years ago, got breath tests and stool tests by Genova and an endoscopy procedure done a few years later as a follow-up. No more acid reflux after the antibiotic treatment but still not able to consume tomatoes or vinegar, even apple cider vinegar, and feels heavy in the stomach after eating meat. She started taking two capsules of HCl for two years but started having the same duodenal ulcer pain she had years ago. Are you going to cover treatment for duodenal ulcer possibly caused by H. pylori and antibiotic therapy?

Chris Kresser:  HCl on its own, two capsules especially, I’ve never seen any evidence suggesting that it causes thinning of the stomach lining. What’s more likely in this case is that this patient has an ulcer. They have H. pylori. Maybe H. pylori has come back. That’s very common even with triple-antibiotic therapy. Complete eradication to zero is unlikely, and often patients will have a recurrence. Depending on how they’re tested, that may or may not show up. Frequent testing once a year at least is what we recommend in that kind of situation. They may also have diet and lifestyle practices that are contributing to core function of the stomach. Chronic stress, for example, can be really problematic obviously and has to be addressed. HPA axis dysregulation, SIBO, and other got infections further down in the digestive tract affect the stomach, particular food intolerances that need to be addressed. Then there are things like mastic gum, DGL, bone broth, and other compounds that can help regenerate the stomach lining as well as vitamin C and collagen.  There’s a lot to consider there. We don’t specifically cover treatment of ulcers in the course, but we do talk about some of the surrounding issues like I just mentioned.