With the recent listeria outbreak in Dole salads leaving 2 dead and 17 sick, I wanted to bring to light another terrain conversation. Risk of infection. Is it the same for everyone? No. Not for this and not for nearly any other infection. This NPR story from 2011 briefly explains the partial mechanism for this risk -- why does one person get sick and someone else does not? Terrain.
Low stomach acid conditions contribute to more infections and disease manifestations than we often hear about. Those on proton pump inhibitors (PPIs) or other acid reducing medications (like H2 antagonists) amounts to approximately 10-20 million Americans, while >20% of Americans have disease states that include at least weekly symptoms of reflux. Low stomach acid signs and symptoms such as frequent burping, indigestion, reflux/GERD, nausea, vomiting, slow or fast gastric emptying, dumping syndrome, cramping, heaviness in the stomach after eating, to name a few, are at a greater risk for pathogenic bacteria and viruses such as H. pylori, C. diff, cholera, coliforms and even recent papers have suggested low stomach acid as a risk factor for COVID-19 and severity through the oral-fecal route.1,2
The interesting thing is that we are also seeing improvements in COVID-19 patients using drugs like famotidine (Pepcid).3 But wait, I thought you just said low stomach acid was a risk factor for COVID-19? Yes, I did. However, once someone is in the throes of a cytokine storm, the mechanism of blocking histamine in the stomach and the mast cell activation aftermath seems to offer benefits to some (PPIs have not shown this effect because they do not address the H2 receptors in the parietal cells of the stomach).4,5,6
The pathogens will keep coming. Are you prepared? Fix the terrain.