Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Monday, October 12, 2009

Biofilm Transformation, Helicobacter, Klebsiella

Helicobacter pylori causes stomach cancer, but it feeds on hydrogen gas produced by Klebsiella pneumoniae in gut biofilms. DNA released by biofilm bacteria not only transfers antibiotic resistance, but it also provides protection against host antibacterial peptides, such a cathelicidins and defensins.

Exploding Labs

When I was working on host/pathogen interactions and plant disease resistance, I also became familiar with research on the formation of the plant equivalent of cancer, crown galls, and symbiotic bacterial nitrogen fixation. I mention this, because this also exposed me to the free-living bacterial nitrogen fixing system in Klebsiella and to the memorable urban legion of exploding labs. As the story goes, as bacteria convert atmospheric nitrogen gas into ammonia, nitrogen fixation, they use high energy electrons, e.g. from ferrodoxin, and lots of ATP, but they also produce hydrogen gas. In labs where they are researching nitrogen fixation, the excess hydrogen gas would accumulate on the ceiling until... boom! Now those labs are properly vented.

Helicobacter Uses Hydrogen as an Energy Source

Helicobacter pylori is considered the most common bacterial pathogen of humans and is the primary cause of ulcers and stomach cancer. H. pylori lives in the stomach by neutralizing stomach acid with ammonia. Another interesting ability of this bacterium is its ability to use hydrogen dissolved in circulating blood as an energy source. The high energy electrons from molecular hydrogen are transported to its electron transport chain, and the energy is used in membrane transport and ATP production. The circulating hydrogen is produced by gut bacteria.

Klebsiella Is not just a Soil Bacterium, Gut Gases

Klebsiella pneumonia is a lung pathogen and it also forms gut biofilms. Presence in the gut and the ability to produce hydrogen gas has some implications for hydrogen utilizing bacteria like H. pylori. Clearly, the stomach of someone with an abundant source of hydrogen fuel in their blood is a better target for H. pylori colonization. This explains why even at age 50, individuals who were exclusively breastfed have a lower incidence of H. pylori and stomach cancer, since even a single bottle of formula can shift an infant to adult, i.e. Klebsiella gut flora.

Klebsiella Needs Carbs to Produce Hydrogen

K. pneumoniae has been associated with Crohn’s Disease and Ankylosing Spondylitis. It grows in gut biofilms and produces pullulanase, an enzyme that can utilize the branched glucosides left over from the action of amylase on plant starch. So K.p. has an untapped food source and it needs lots of ATP to produce hydrogen gas. The nitrogenase needed for nitrogen fixation and hydrogen production is very sensitive to oxygen, so this means that K.p. needs a partially anaerobic environment and must get its energy from fermentation. Fermentation yields much less ATP than respiration using oxygen, which means that K.p. can only produce hydrogen with lots of glucose from starch.

Low Carb Diet Cures Crohn’s Disease

It turns out that the antigen causing Crohn’s disease is the pullulanse (with collagen mimetics.) As you should expect, it has a basic triplet. Eating a low carb diet reduces the flareups of Crohn’s disease, presumably by starving out the K.p.. It is interesting that nitrogenase is the antigen involved in Ankylosing Spondylitis.

Biofilms Promote Transformation and Antibiotic Resistance

Just as a footnote to the benefit of K.p. as a citizen of a biofilm community, H.p. should also live in those biofilms, since that is the source of the hydrogen it uses. Biofilms also stimulate the exchange of DNA, because the quorum sensing chemical signals trigger the release of DNA. The DNA is a component in the matrix that binds bacteria in the biofilm and can work in conjunction with bacterial acidic polysaccharides and host heparan sulfate. These acidic polymers tend to bind the basic antimicrobial peptides, e.g. defensins and cathecidins produced as a major non-adaptive defense against bacteria. Thus, the release of DNA triggered by quorum sensing, builds matrix, facilitates DNA transformation that is the foundation for the spread of antibiotic resistance in gut biofilms and provides resistance against antimicrobial peptides.


Peter said...


I guess you could regard the respiratory population as an out-group of the gut population, using the blood stream to transport hydrogen from an anaerobic site to an aerobic site....


Dr. B G said...

Dr. Ayers,

Beautiful post!!!!

I didn't know about the exploding LABS...!

Reminds me of our first experiment in Advanced Bio with Mr. Degusta... all he did was make WATER... beautiful... H20.

Amazing how H. pylori and our cells harness power and energy... I love your host-bio stories.


Dr. Art Ayers said...

K.p. can grow in the lungs and cause problems. In hospital studies, lactoferrin was fed to patients to decrease iatrogenic pneumonia. It was very effective, because it killed/eliminated the bacteria at their source, the gut.

K.p. in the lung couldn't get access to the starch-derived nutrients that it needs for H2 production and oxygen would be a problem for the nitrogenase until a protective biofilm of oxygen consuming bacteria accumulated.

Thanks for watching and commenting.

Wild One said...

A wonderfully informative article. I recently learned an old friend had died of stomach cancer; he had suffered with ulcers since childhood. A terrible affliction these bacterium can cause, but this kind of solid research can help put an end to it. Makes one wonder how many other symbiotic relationships contribute to illness. Thank you for sharing!

Dr. Art Ayers said...

H.p. is, in my opion, still underdiagnosed. It can be easily treated with antibiotics (and alcohol and herbs), but even with treatment in reoccurs. It has been known by physicians for decades. Reoccurrence is more likely, because the H.p. resides in tooth plaque biofilms (and probably intestines as well.) Plaque (and intestinal) biofilms should be removed before antibiotic treatment, to be effective.

Thanks for your comments.

StephenB said...

Tooth plaque biofilms succumb to vitamin K2-MK4. Taking 5mg/day makes my teeth squeaky clean, which can be felt by running the tongue over them. Stephan Guyenet wrote "Certain organs such as the brain, pancreas and salivary gland show an overwhelming preference for MK-4 over K1 in rodents and humans." I think there is a reason for this.

Unknown said...

so cool

Dr. Art Ayers said...

I also noticed a recent paper that found evidence for menaquinone (vitamin K2) production by an alternative pathway in E. coli and Chlamydia. In addition to being a human source for this vitamin, this brings up the possibility of using menaquinone as a reducing agent for Klebsiella nitrogen fixation and hydrogen production. This speculation would provide potential biofilm collaboration between aerobes/anaerobes, hydrogen produces/consumers, vitamin K2 redox pairs, etc. All of these collaborations would be advantageous to pathogens living in the harsh environment of the human body in the midst of medical interventions.

jean said...

Dr Ayers,
Your series on biofilms is fascinating and so helpful, I hope you continue to help me understand this relatively new aspect of disease.
I haven't worked as a nurse for 10 years now, but before that I spent 20 years in the surgical/trauma/burn ICU at a university affiliated hospital.
The I.D. service was operating in the dark ages and we had unbelievably infected patients (due to their injuries), many with obvious signs of infection but no culturable organisms (that we could find, and we really tried). It strikes me that we were creating problems for many patients who were treated for infection while the cultures were growing. Inevitably, it was the wrong antibiotic; some patients would get 2 or 3 antibiotics while waiting for the culture to come back. Also at that time, one of our biggest fights was getting the docs to just FEED the patients. Early use of the gut was just coming into vogue at that time as translocation of gut organisms to the lung was starting to be taken seriously. We pushed hard for feeding tubes and early feeding, can figure how that went. But now that I think on it, most of the formulas were HFCS based with appropriate protein, but I think it was mostly soy based. A true testament to the human body that people did survive.
I really look forward to the biofilm columns and comments. Thanks again. Jean


Peter said...

"This speculation would provide potential biofilm collaboration between aerobes/anaerobes, hydrogen produces/consumers, vitamin K2 redox pairs, etc"

My copy of Power Sex and Suicide is in storage at the moment, but this bacterial collaboration is making me think of the mitochondrial genesis hypothesis....


Kyle Schneider said...

Hi Art,

Off topic comment: I’m adding Vitamin D drops to my regimen (2000 IU per drop)….heard they absorb better when ingested w/ some fat. What do you recommend I take it with to maximize my body’s absorption? Currently I’ve been putting 2 drops in a tsp of fish oil and swallowing. Let me know your thoughts, and thanks again for everything! Blog is great.



Chris Kresser said...

Hi Dr. Ayers,

I just discovered your blog, via Stephan's Whole Health Source.

I'm interested in biofilms because I have Crohn's disease, and biofilm formation (esp. E. Coli) has been associated with CD.

What do you think about the use of enzymes and EDTA to disrupt biofilm formation? Klaire Labs is making a product called Interfase Plus that they are marketing as a biofilm disruptor. Apparently EDTA binds to magnesium, iron and calcium which are necessary for biofilm formation, and the enzymes lyse the extracellular polymers commonly found in biofilm as well as degrade bacterial and yeast cell wall structures.

I'd love to get your opinion on this if you have the time.


Dr. Art Ayers said...

My initial impression is that EDTA and enzymes should be effective against biofilms, but what is the next step?

I think that you just have your choice of alternative biofilms, good or bad. I see stripping biofilms as a one shot, drastic measure and should not be done continually. That said, the next step is producing a healthy gut flora that will supplant bad biofilms.

In order to benefit from a more severe stripping of biofilms, it seem to me that it is important to attempt to establish a beneficial gut flora first and then hope that remnants of that flora will replace the bad biofilms after the stripping. That suggests pre- and probiotics (e.g. leeks and apple; inulin and pectin, plus live yogurt.)

I am not much of a user of commercial products.

Thanks for your comments.

Mrs. Ed said...

With your interest in biofilms you might find this little piece of history interesting. In 1951, Pediatrician Dr. Sidney Haas published a book, in 1951, called "The Management of Celiac's Disease". He was the first MD to actually successfully treat Celiac's with a diet. This was before the discovery of gluten. Unfortunatly the diet was nicknamed the Banana Diet. He disovered that removing grains, starches and most sugars for a period of about a year brought the disease into remisssion, and even appeared to,cure. He suspected that some sort of bacterial thing was going on and the diet seemed to starve out whatever it was. The diet was considered "the" diet for this at the time. Then they discovered gluten and the diet was dumped. This may have been the first biofilm treatment diet, and it was being used 80 years ago.

Also of note, he describes an odd behavior in the more serious patients, and goes on to describe what we would now know to be autistic behavior. He notes that this odd behavior usually clears up within two weeks of the diet (my son's made a drastic leap 3 weeks into it).

Now the SCD is being used by those with Crohn's and Autism, and usually against the approval of doctors.

I'll have to read more of your biofilm posts.

Dr. Art Ayers said...

Hi Mrs. Ed,
I remember reading about Dr. Haas' work a couple of years ago, when I first looked at celiac and diet. Almost all of the things that I find to be important in disease prevention are supported by decades old research. Medicine has gone way off track from prevention to lucrative treatment.

I think that we should think about cultivating healthy gut flora and biofilms as an important dimension in diet and health. Yet all of the advice from the health industry and agribusiness is dangerous to our health.

Thanks for your interest.

Anonymous said...

Dr. Ayers,

Your post and your following comments were very informative.

My wife, Pat,recently had a barium xray which, according to the phone report just received, showed indications of several small ulcers.

The doctor prescribed Prilosec which seems to me is a very bad idea as the lower acidity in would encourage increased growth of h.pylori. The side effects of Prilosec are said to be pretty bad.

My wife (age 73 and currently on no meds) has lost a lot of weight in the last couple of years, from 125 lbs to 100, and has muscle weakness as well. An abundance of tests has found nothing save for the recent barium exray results.I suspect the problem is largely due to antibiotics taken for several urinary tract infections, and more recently a cat, bite which caused gut problems. For that reason more antibiotics does not seem like a good idea.

We eat a fairly low carb diet similar to what you describe as anti-inflammatory. Her vitamin D-3 is low (18)but Pat is sensitive to D3 supplements so she is trying to get a lot of sun while the summer lasts.

You mentioned that lactoferrin and vitamin K2 could possibly inhibit h. pylori and those options sound good to me. I suppose raw milk cheese, which I can get locally, would contain vitamin K2 as well as lactoferrin, but Pat does not tolerate the cheese well.

I would appreciate your thoughts on Prilosec, lactoferrin, vitamin K2 and anything else you might think worthy of consideration.

Thanks, Jack

Dr. Art Ayers said...

Jack C.,
Ulcers are usually the result of H. pylori, as you indicate, but there is currently some speculation that most people live with H. pylori and have no symptoms. That suggests that the ulcers and cancer associated with H. pylori result from a disruption of the normal environment in which the H. pylori normally lives peacefully.

Your wife has a lot of food intolerance and can't take vit.D3. This indicates that her gut flora is messed up. That is consistent with prior antibiotic use.

I think that she would improve with probiotics and development of her gut flora, as I suggest elsewhere on this blog. She is probably also constipated and may suffer from intestinal yeast infection.

She needs to persistently expand her diet and improve her tolerance to foods, i.e. her gut flora diversity, by gradually increasing exposure to the foods that cause digestive problems. Her bowel movements should gradually normalize. She should eliminate the use of laxatives. Antibiotics will make her long term cures harder. She also needs to increase her physical activity and build muscle strength.

Sun exposure won't help with her vit.D deficiency until she lowers her diet-based inflammation. Increasing the saturated fat in her diet may improve her tolerance of fish oil. She is probably not eating enough calories, because she lowered her carbs, but didn't increase her saturated fat consumption to compensate for the lost calories.

I think that her ulcers are just symptoms of her disrupted gut flora and eating better can eliminate all of her problems.

Let me know of her progress. Continue to ask questions and read more of my articles.

Angel said...

Hello! I always love reading your posts, thank you for sharing this information. Before i read this post i thought that it was klebsiella LPS leaking from the gut that people with AS react to.

Do you think that eating good live probiotics can take away klebsiella biofilms? Or do you think that some food can help take them away?

I have a friend with ankylosing spondylitis, but he refuses to go on a no starch diet. I also think that the diet isn't so good since it doesn't fix the problem. The bacteria is still there, just waiting to have some food.

I know that eating wheat and oat bran raises bifidobacteria, but is there something more he can do besides that? He has started to eat more fibre like whole grain rice, wheat bran and less sugar. He also eats some home made yoghurt with "lactobacillus acidophilus La-5, bifidobacterium lactis bb-12, streptococcus thermophilus and lactobacillus delbrueckii subsp. bulgaricus".

I am grateful for any thoughts you might have on this.


MasK said...

Hello Dr Ayers.
Can you explain the following :

"Sun exposure won't help with her vit.D deficiency until she lowers her diet-based inflammation. Increasing the saturated fat in her diet may improve her tolerance of fish oil. She is probably not eating enough calories, because she lowered her carbs, but didn't increase her saturated fat consumption to compensate for the lost calories."

What is the link between the inflammation and the capacity of using or processing Vit D?

And what is the link between gut flora and this capacity?

Thank you very much

Dr. Art Ayers said...

Diet-based chronic inflammation decreases the ability of the skin to produce vit.D. Thus, people exposed to high levels of solar radiation, e.g. Southern California or Florida, frequently have vitamin D deficiencies, because of bad diets. The anti-inflammation diet that I recommend fixes the diet and permits vit.D production. Vit.D3 supplements also lower inflammation and permit a return to solar production of vit.D in the skin.

Dysfunctional gut flora can produce inflammation in a variety of ways, e.g. vitamin and mineral malabsorption, or dysruption of normal immune function via the GALT.

Thanks for the question.

Dr. Art Ayers said...

I wouldn't recommend wheat and especially not bran, since they both produce additional problems.

Klebsiella is associated with ankylosing spondylitis, but I am not sure how they are connected. It could be via LPS or other bacteria components or it could be through the impact of these compounds on the gut immune system.

I don't think that probiotics can impact the Klebsiella directly, since they are in different parts of the gut, but the probiotics may alter the composition of the immune system and alter the course of the disease.

It is also possible that stripping the gut biofilms with PEG, EDTA and enzymes, as described in another of my articles, would provide an opportunity to recreate a healthier gut flora. Some people with related conditions show relief from the total bowel irrigation that precedes a colonoscopy, because it also strips away the biofilms.

He might also benefit from the Eades diet that I explain elsewhere. That diet approach involves another treatment with milk whey that may provide a transition to a low carb diet that is healthier in general and may also treat AS.

Please read my other articles on reestablishing gut flora to avoid the misconceptions about fiber. Bran is not healthy, it merely produces mineral deficiencies. Healthy fiber that nourishes gut flora is plant polysaccharides that can be digested by bacteria in the colon, e.g. pectin and inulin. I would recommend for AS to avoid grains, starch and sugar. Look at my anti-inflammation diet. It is readily adapted for diabetics, gluten intolerance and other diseases that benefit from low carbs. Most people find it very easy to shift to it, since it is very satisfying.

Thanks for your questions/comments. Let me know if I can provide more info or suggestions, and tell me how it works out.

MasK said...

"Bran is not healthy, it merely produces mineral deficiencies."

Is this caused by phytic acid? This acid is found in many substances other than bran, I think.

Can you explain further why bran is not good? I eat some oat bran, to feed the flora, at least this is what I think! Thank you again.

Jack said...

Hi. Are my posts getting deleted by the system? I see them posted when I submit, but then they disappear right away.

Dr. Art Ayers said...

I don't think that the issue is carbs, but rather starch versus soluble fiber, e.g. pectin or inulin in fruits and vegetables. Normal stools require a large volume of packed gut bacteria. Growth of gut bacteria is dependent on protein, fat and polysaccharides that reach the colon. If the bacteria in the colon are diverse enough (roughly 100 different species of bacteria), then anything animal or vegetable that is tossed in will be digested. In the absence of diverse bacteria, some of the material will pass through in the stool.

On a low carb diet without many veggies, little will pass through to feed the bacteria and very small volume of stools will be produced. Stools are packed bacteria, so most of the stool volume comes from plant polysaccharides that human cells don't produce enzymes to digest, i.e. everything except starch.

Mucin is produced independent of dietary carbs. Without mucins, you would be in trouble, but I don't think that high or low carbs will alter the mucins. I was not convinced by the article that you cited.

Hydrogen production by gut bacteria is a necessary part of gut function. I personally don't think that H.p. is a problem when it is getting mostly hydrogen for its energy. I think the problems occur when too much starch is being digested and glucose is abundant.

Thanks for the comments and questions.

Jack said...

Dr Ayers,

Thank you very much for taking the time to respond. I have read your reply a few times and I think I understand. But just to make sure...

It seems that what you are saying is:

1. starchy carbs pose more of a problem for me than 'carbs' in general, like fruits and veggies.

2. fruits and veggies will produce a wider array of gut bacteria, and this could be beneficial to me because H.p. could feed off of a normalized level of hydrogen, rather than looking for starch and/or glucose.

That leads to me to think that when I went low carb, the diversity of gut bacteria was dramatically reduced, forcing resident H.p. to scavage for other sources of energy, causing a change in the normal pattern of H.p. and thereby an overgrowth as a result. This is then causing my esophagus sphincter to get cranky.

Is that pretty accurate or am I out in left field?

The odd thing is that on my old diet, I ate tons and tons of carbs, including white breads, potatoes, rice, pastas, sugars… all kinda bad stuff, and I didn’t have heartburn. Don’t get me wrong, I feel better in all other respects in the last 4 months, and I’ve lost 11 pounds and gained significant muscle mass.

Chris Kresser recommends that I do the urea breathe test to confirm an H.p. infection and take HCL tablets with my meals. I would have to order the kit from my physician so it will take a bit before I can get the results back.

In the meantime, would you say it's best to increase my veggie intake, as well as more fruits?

Also, do sprouted grain breads count as 'starchy' carbs? I do not eat white flour products anymore, but I do have a piece or two of sprouted bread daily for a vehicle for pasture butter.

Sorry for such a long winded post. I am also seeing my physician but people like you with the right mind for this sort of thing is really a staple resource for me to be able to get to the bottom of this annoying issue.
I really appreciate your unique perspective Dr Ayers.

Jack K.

Dr. Art Ayers said...

Starch is starch and all grains are predominantly starch. I have stopped routinely eating breads to avoid insulin spikes. Saturated fats are healthier and more satisfying. Plenty of veggies are better than fruit, to avoid fructose, sucrose and starch.

I think that it is clear from many studies that GERD is not caused by Helicobacter pylori. In fact, Hp, because it inhibits stomach acid production, is protective for GERD. GERD frequently results from antibiotic elimination of Hp in the treatment of ulcers.

GERD is associated with a different bacterium in animal studies. I think that GERD is parallel with ear infections. Ear infections occur when the Eustachian tube is obstructed by inflammation of the surrounding tissue. In GERD, the inflammation stops the proper collapse of the base of the esophagus so the stomach acid can slosh or be pushed upward. The difference, is that bacteria growing in the dammed up middle ear contribute to the ear infection, whereas infection/inflammation of the esophagus keeps it from closing when acid builds up.

After GERD is established, I think that it is like asthma, in which the restructuring of the tissue reinforces the condition. It seems important to avoid the mechanical conditions that bring acid in contact with the esophagus while returning the rest of the GI tract to normal. That suggests small meals, empty stomach at bed time and avoiding postures that permit the acid to flow upward.

This isn't very satisfying, but I hope it is a little helpful.

Jack said...

Dr Ayers,

Thanks for you additional input.

This part makes me a little nervous... "the restructuring of the tissue reinforces the condition".

Hopefully I have not done irreversible damage to my cells involved in this. It's only been about 3 months. I am bent on 'fixing' this problem. I cannot accept "just living with it".

I will cut down even further on grains, even sprouted. The most fruit I have is a handful of blueberries (normally eaten with heavy cream) or maybe a half of a very small banana with cream. Sometimes a slice of watermelon but not very often.

The H.pylori dealio is pretty confusing to me. I am just trying to figure out what to eat/what not to eat to restore normal gut flora. So thanks very much for your comments.


Paul said...

Doctor Ayers : What can you recommend for diverticulosis ?

Dr. Art Ayers said...

My first suspicion with any disfunction of the colon would involve nutrition to the colon cells and signaling for colon development. Colon nutrition is derived from the short chain fatty acids produced by anaerobic fermentation of soluble fiber by gut flora. Signaling is also from the gut flora.

Diverticulosis is frequently accompanied by constipation, which is a deficiency of gut bacteria. There is also a weak association between a decrease in symptoms with increasing dietary fiber. Both of these point to gut flora as the source of the problem.

It would seem that the anti-inflammatory diet that I recommend on this site would be an obvious starting point. Get your serum vit.D checked and make sure that you are eating a wide variety of fresh vegetables to provide needed colon bacteria, as well as soluble fiber. There are hundreds of different species of gut bacteria and hundreds of different plant polysaccharides that are soluble fiber. Avoid grains.

Let me know how this works out.

Paul said...

Dr. Ayers , Thanks for the response for the diverticulosis. You cautioned me about grains before ; which I have been consuming for many years through bread products. What type of breads shuld be used for a sandwich ?

Paul said...

Dr. Ayers I was also on antibiotics
since late August of last year.
Once I completed them, I developed a C Diff infection.


Anonymous said...


I use romaine (most nutritious) lettuce leaves for sandwich wraps instead of bread.

Paul said...

Dr. Ayers ; Can you respond to my last comments when you have time.
Thanks ; doctors are of very little help when it comes to these kind of problems


Anonymous said...

Dr ayers,
I would really appreciate any insights on this…I've battled chronic diarrhea for years, eventually diagnosed with crohns , due to the presence of mild chronic inflammation thru out my small bowel (from capsule endoscopy). I've been working with a functional medicine MD and recently had a stool test that showed h.pylori, no growth of e coli or lactobacillus, and large amounts of growth of alpha/gamma heamolytic strep. All this despite, following a paleo-ish diet and tons of fermented food. I was on antibiotics for years (acne), which I think lead to my present state. My doc wants to treat the h. pylori with conventional antibiotics, but I'm a little gun shy given the current state of health of my gut and past history. Any thoughts?

Thanks so much in advance,

Dr. Art Ayers said...

My first impression is that you have tried half of the cure. The medical community seems unaware of recent research showing the complexity of the normal gut flora. You identified the problem as inappropriate use of antibiotics to treat acne and changed your diet.

Unfortunately, you didn't successfully recruit the hundred plus new species of bacteria needed to get your colon flora and its immune system functioning. That is the part of the immune system needed to suppress immune system attack on the gut. Loss of these bacteria is typical of the symptoms of Crohn's.

The quick fix would be a fecal transplant. Slow and steady eating of diverse veggies with clinging soil bacteria will build up the needed gut flora community to get your immune system functioning properly.

More antibiotics to fix the Helicobacter would seem to only contribute to the problems. The presence of H. pylori may be keeping your Crohn'-like symptoms in check.

Let me know what happens.

Bob Connors said...

Hi Dr. Ayers,

I found your blog last night through Stephan Guyenete's site and am pretty sure my wife is about to divorce me if I don't stop reading and get some sleep...

I have ankylosing spondylitis and after experimenting for 5 years with the no-starch diet have ended up with a diet almost exactly like the one you recommend.

I've had great success with my diet but was recently reading on and considering antibiotics to augment my dietary treatment of AS. Not sure if it's overkill at this point since I've had such good success using my version of the NSD. Do you have any thoughts on using antibiotics to treat AS?

Second: I've always been concerned about using probiotics as I'm not sure if K.p would be given some sort of advantage as you introduce other bacteria. Irrational fear? Probably, but now that I've gotten my flares under control I'm a little reluctant to mess with a relatively good thing. Pain is a cruel teacher. Should I add probiotics to my regimen?

I'm a little obsessed about spreading the word on dietary treatment for AS and have started a blog ( to do my part for the AS community. Was wondering if you could help point me in the right direction in regards to scientific papers and researchers who are studying Klebsiella, AS, etc. Pubmed and Google Scholar are great, but lots of wading through not so good stuff to find the gems.

My email address is if there's any way you'd consider emailing me a few primary sources or other advice.

Thanks so much for this fantastic blog!

Bob Connors

chemist said...

Hey Doc,

Have a lengthy history of crohn's, but have been managing things well with your diet suggestions. i still have some lingering symptoms, primarily looser stools and am always looking for alternative treatments. read a study using mastic gum for crohns which looks interesting. i do have h pylori, but never treated it based primarily on your suggestions that it may be helping to keep my immune system in check. any thoughts about the use of mastic? it doesn't seem to be a great h pylori killer and I would be interested to see if it improves any of my crohns symptoms, but am slightly concerned that it could still knock it out. thanks in advance.

TAP said...

I found your article when I started wondering about whether there is a connection between a virus I had while in Alaska, and the now chronic inflammation of my esophagus and ulcers. Following a violent stomach virus, I was diagnosed with klebsiella uti, and took antibiotics, I had chronic uti's all of my life until after the birth of my son, when they seemed to miraculously go away. However, following this virus, they became chronic again, and still are. Around the same time, I developed a stomach ulcer and gerd, and went on a 5 month course of Prilosec. I seemed to heal ok, but then 2 years later, I developed the same condition again. Ulcer, gerd, and still chronic uti's. When I was scoped 2 years ago, I was told H pylori was not an issue. This time the recommended medical regime seemed to heal the ulcer, but not the inflammation of my esophagus and gerd. I'm only 43, and am concerned about this continuing because I know the cancer risks. I have been taking some things recommended by my health food store, such as neem, licorice, orange peel, probiotics, etc. I get the most relief from chewing on cardamom seeds, strangely. Do you have any thoughts on all of this?

Unknown said...

Dr. Ayers,
I stumbled upon your website while researching my recently diagnosed ankylosing spondylitis. I've been on a paleo diet for two years with little success. I started fermenting my own vegetables for Hashimotos. They are somewhat helpful. Now I'm adding resistant starches (PHD). My doctor put me on Embrel and LD Naltrexone two weeks ago and just from a day spent on your website, I think suppressing my immune system is the wrong approach. Would you agree?


Mel said...

This blogpage is so relevent to me!I have KP living in my gut and have been attempting to get its numbers down for the past 2 years, with some success.
Any help you can give me would be very helpful and very much appreciated.
I get no support from my own GP as the KP was found using a private doctor and lab by myself after I had been suffering from this same issue since my early teens and getting steadily worse by following NHS advice.She therefor does not recognise the test result or any of the methods I am using to combat it.I am on my own with it basically.I do have online support from a facebook group of patients of a Dr Sarah Myhill,an enviromental Dr from Wales, but she has too many patients on her books and isn't accepting any more.I haven't been able to gain a career due to this problem and we don't have any money to spare in trying to find a private doctor who will work with me on it,or to pay for any health insurance which would cover it as our household finances are extremely stretched already.Thankyou for posting this information.

Melanie Stephen

Anonymous said...

hi Dr Ayers

Not sure if reading this correctly. Could taking Lactoferrin supplements assist in the management of Crohns disease by eliminating kP? I was diagnosed with Crohns a few years ago and found the low carb / SCD to be the best way to stay in remission.

Only just discovered your blog. Very grateful for the work you do.