Proton Pump Inhibitors (PPIs)

I've been on Lanzul for over three months now to block stomach acid; spent the first month and a half dealing with gastritis, then just trying to stop my stomach from triggering gallbladder attacks.

But lately, I feel like things are shifting in my gut; first there were these uncomfortable cramps (even though my stool was okay, just a bit darker), and then after I caught a UTI, the pain spread to my back... honestly, felt like my kidneys. When my stool turned really dark and looked like it was leaving red streaks in the water, I totally panicked and went for a urinalysis—found quite a few white and red blood cells. My GP put me on a broad-spectrum antibiotic right away since we didn't have time for a culture before the long holiday weekend.

After four days on the antibiotics, my stool started looking better, lighter, and those cramps finally eased up.

So I'm wondering... I've heard stories that stomach lining inflammation can actually happen from a lack of acid too, when bacteria start multiplying in the stomach or the lining itself. If they prescribe a proton pump inhibitor on top of that, things might actually get worse. Those bad bacteria spread to the intestines, and from there, it's a short jump to a UTI.

Since I never really had symptoms of excess acid—actually, I always felt like I had too little, like how I could handle spicy food pretty easily—I'm questioning if they misdiagnosed why I have gastritis. They didn't find any HP, though they did note it wasn't in the specific sample they took.

Has anyone else ever thought about this?

So, because you "digested" spicy food easier, you've suddenly decided you're low on stomach acid? Interesting logic there...

But honestly, the even bigger leap is this massive jump to urinary tract issues

Glad I could keep things interesting for a bit...

I highly doubt I have low stomach acid—it’s been years now. I tend to get full pretty quickly, even if what I'm eating isn't particularly heavy. Plus, heartburn just isn't an issue for me.

And honestly, every woman knows how easily bacteria can travel from the rectum to the urinary tract. That’s why hygiene is such a huge deal (without getting too graphic here).

What I'm really wondering about is whether low stomach acid could actually make you more prone to bad gut bacteria. I've read bits and pieces about it online, but I'd love to hear some perspectives...

Basically, I'm trying to figure out why the antibiotic I'm taking for my UTI seems to be fixing my gut issues too. It's weird because neither dietary changes, probiotics, nor Pepcid have made a dent in those symptoms.

Look... stomach acid doesn't really travel down into the intestines, so I don't think you can pin the issue there. As far as the stomach itself goes—well, things might get complicated if your acidity levels actually take a massive dive...

I've been using Lanzul myself lately—I was on Pepcid before this—and honestly, I never had any trouble with them.

First off, sorry if my post yesterday came off a bit "rude." It wasn't—just one of those days where everything sucks.

Let’s just reset here. If we actually take a second to think about this, some answers might actually make sense.

Susan Brooks48 said:Glad I could keep things interesting for a bit...

I highly doubt I have low stomach acid—it’s been years now. I tend to get full pretty quickly, even if what I'm eating isn't particularly heavy. Plus, heartburn just isn't an issue for me.

And honestly, every woman knows how easily bacteria can travel from the rectum to the urinary tract. That’s why hygiene is such a huge deal (without getting too graphic here).

What I'm really wondering about is whether low stomach acid could actually make you more prone to bad gut bacteria. I've read bits and pieces about it online, but I'd love to hear some perspectives...

Basically, I'm trying to figure out why the antibiotic I'm taking for my UTI seems to be fixing my gut issues too. It's weird because neither dietary changes, probiotics, nor Pepcid have made a dent in those symptoms.

Look, people dealing with hypochlorhydria don't usually get "full quickly." They’re constantly hungry, always battling allergies, and dealing with random infections. If you really sit down and connect the dots, you'll see why.

Anyway, I've got a few questions for you. What was the actual reason you ended up at the doctor—what symptoms were you having that triggered a gastroscopy?
When did the intestinal cramps start? And the changes in bowel movements... how long has that been going on?
Besides Lanzul, are you taking anything else?

Yeah, taking just the blocker shouldn't be an issue since they don't really have side effects. But the thing is, we're swallowing a whole bunch of bacteria that has to survive the stomach to settle in the gut. It makes sense that they'd have a much easier time passing through if the stomach acidity is lower. Right?

Susan Brooks48 said:I've been on Lanzul for over three months now to block stomach acid; spent the first month and a half dealing with gastritis, then just trying to stop my stomach from triggering gallbladder attacks.

But lately, I feel like things are shifting in my gut; first there were these uncomfortable cramps (even though my stool was okay, just a bit darker), and then after I caught a UTI, the pain spread to my back... honestly, felt like my kidneys. When my stool turned really dark and looked like it was leaving red streaks in the water, I totally panicked and went for a urinalysis—found quite a few white and red blood cells. My GP put me on a broad-spectrum antibiotic right away since we didn't have time for a culture before the long holiday weekend.

After four days on the antibiotics, my stool started looking better, lighter, and those cramps finally eased up.

So I'm wondering... I've heard stories that stomach lining inflammation can actually happen from a lack of acid too, when bacteria start multiplying in the stomach or the lining itself. If they prescribe a proton pump inhibitor on top of that, things might actually get worse. Those bad bacteria spread to the intestines, and from there, it's a short jump to a UTI.

Since I never really had symptoms of excess acid—actually, I always felt like I had too little, like how I could handle spicy food pretty easily—I'm questioning if they misdiagnosed why I have gastritis. They didn't find any HP, though they did note it wasn't in the specific sample they took.

Has anyone else ever thought about this?

That just doesn't hold water. Most UTIs actually come from the digestive tract, but we’re talking about "homegrown" bacteria—just the normal stuff living in your gut—so it’s got nothing to do with what you eat or your stomach acid. If you want to avoid issues, it really just comes down to basic hygiene and fixing whatever else is triggering them. As for proton pump inhibitors? Huge thumbs up there. So many people are living much better lives thanks to them.

Susan Brooks48 said:Yeah, taking just the blocker shouldn't be an issue since they don't really have side effects. But the thing is, we're swallowing a whole bunch of bacteria that has to survive the stomach to settle in the gut. It makes sense that they'd have a much easier time passing through if the stomach acidity is lower. Right?

Actually, no.
Thanks to that super acidic stomach pH, most of those microbes aren't even going to make it—they get wiped out almost instantly. Your normal gut flora consists of over 400 different species, and for most people, it stays pretty much the same throughout their lives. The distal ileum acts as this transition zone between the sparse flora in the upper digestive tract and the dense population in the colon. This natural flora basically creates a defense system against other types of bacteria or fungi trying to move into that "ecological niche."
There are several components that protect the intact intestinal lining, plus—if you actually have a decent immune system—even if some bacteria manage to translocate, they just get phagocytized and destroyed by the intestinal lymphoid tissue and liver phagocytes.
Bottom line: successful penetration by anaerobic bacteria can really only happen if there's a major break in the mucosal continuity or if necrosis sets in.

Achlorhydria or hypochlorhydria can cause the bacterial flora (the kind usually found in the colon) to proliferate in the upper parts of the small intestine (what's known as blind loop syndrome), which leads to megaloblastic anemia, frequent diarrhea, and all sorts of other signs and symptoms of malabsorption syndrome.

Anything else?

Honestly, I'm just lost. I’ve been healthy my entire life, but this past year has been a total disaster. First, I ended up in the ER with terrible nausea and weakness (didn't vomit, though) only to find out I have gallstones—which somehow weren't on my physical a year ago—plus chronic gastritis, reflux esophagitis, and a hiatal hernia from my endoscopy. Because of some cell changes in my esophagus, I have to go back for another endoscopy soon, but they didn't find any HP.
I had my baby two years ago, and that's when the occasional nausea started. My digestion was always fine before that.
About a month and a half after the first gallbladder issue, I had a second attack (dealing with pain for 24 hours using Spasmolytic). My gut would get nervous in the mornings, but after that second episode, I started getting weird cramps during the day too. A bit of a burning sensation.
Then, about ten days ago, my urinary issues started, followed by intense cramping all over my abdomen... really uncomfortable pains and sharp stabs near my kidneys. My stool turned extremely dark, almost black, and there was even a reddish tint in the water. I rushed to get a basic urinalysis done—lots of red blood cells, white blood cells, bacteria, and mucus. I even went in for an abdominal ultrasound out of pure panic. Everything came back clear.
I was prescribed a broad-spectrum antibiotic, and now, five days later, my stool color is back to normal, the cramping and kidney pains are gone, and I feel pretty good. I dropped off a urine sample for a culture yesterday, and today I did a stool test for occult blood just to be safe... just waiting now.
All these tests are starting to wear me down, but when you feel this bad constantly and it’s unlike anything you’ve ever felt... you worry and start coming up with theories.
So, I'm wondering, what could have been going on with my gut that made the antibiotic work so well?

I’ve always found that proton pump inhibitors are quite easy on my system; in fact, I took Lanzul 6 for six years straight without ever missing a beat—well, up until my recent surgery—and I never once dealt with any digestive issues or stomach upsets... so, if you ask me, I suspect there might be something else entirely going on here.