I eat out for a living. It turns out that’s not why my stomach always hurts

I’ve never known what it means to have normal digestion. That’s especially hard when your profession centres on eating. As a food reporter, I usually dine out a few times a week. Since I’ve taken to the road in recent months to scout restaurants around the US for the New York Times’ autumn list of favourites, back-to-back dinners have been the norm. My stomach issues — constipation, acid reflux, diarrhoea, you name it — have been lifelong. But this job has aggravated them.

I know, I know. Eating out for a living? Your life must be so hard! And I’ll admit that sometimes I feel fine after a restaurant meal. Great, even. But more often I’ll be pinned to the couch for hours with a stomachache.

As a teenager, I told my doctor about my digestive woes, and she told me I had acid reflux. I started storing antacid tablets in each of my purses, but all they provided was temporary relief. I was tested for food allergies, but nothing turned up.

A few months ago, as I began my restaurant-scouting trips, I was in pain almost every night. My partner urged me to see a gastroenterologist. As it turns out, a type of bacterium that under a microscope looks almost like a spiral pasta was wreaking havoc on my stomach lining. The bacterium is called Helicobacter pylori, or H pylori, and it lives in half of the world’s people.

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Many people who have H pylori probably contracted it during early childhood, through contact like sharing food or breathing aerosols released from vomiting

—  Nina Salmana

H pylori has evolved in human microbiomes for at least 100,000 years. It came into a bigger spotlight in 2005 when two Australian physicians, Dr Barry J Marshall and Dr J Robin Warren, won the Nobel Prize in Physiology or Medicine for discovering the link between the bacterium and peptic ulcers.

Many people carry H pylori in their stomachs without any negative consequences, but for some it can move into the mucous layer of the stomach and cause a host of problems, from stomach inflammation to ulcers to stomach cancer, according to Nina Salama, a microbiologist at the Fred Hutchinson Cancer Center in Seattle.

Many people who have H pylori probably contracted it during early childhood, through contact like sharing food or breathing aerosols released from vomiting, Salama says. It can also be transmitted through food that was not cleaned or cooked in a safe way, or drinking water that is contaminated with the bacterium.

As hygiene standards have improved in the United States, H pylori has become less common. But it’s still a public-health issue both in the US and elsewhere, including Ireland, where it has been one of the most common infections in adults and is the primary cause of stomach ulcers and stomach cancers. (It is more prevalent in places like Africa and south Asia.)

Salama says that some studies suggested that symptoms could be managed with dietary changes, like eating lots of fruit and vegetables or lowering salt intake. There’s also a treatment: a high dose of antibiotics and acid blockers taken for several days.

Once I started talking about my own challenges, I found others in food-related jobs who had tested positive for H pylori

Before testing positive for H pylori, I had never heard of the bacterium. H pylori is not getting the same public attention as irritable-bowel syndrome, the gut issue making the rounds on TikTok among users who identify as “hot girls with IBS”. It is not discussed in the media as much as coeliac disease, a chronic disorder that makes people sensitive to gluten.

But once I started talking about my own challenges, I found others in food-related jobs who had tested positive for H pylori.

Luisa Weiss, an American cookbook author who lives in Berlin, discovered she had H pylori in 2019. After years of bloating and irregular bowel movements, the positive test “felt like a liberation”, she says.

People do not talk about these sorts of health challenges enough, she says, because they find it embarrassing.“And so they do not realise people are in danger.”

Weiss took the antibiotics but was also diagnosed with coeliac disease. Even though her stomach problems have improved, she is cautious about what she eats. She asks others to help her taste-test food when she is developing recipes and avoids spicy dishes at restaurants.

‘How did the human race become so universally infected?’

—  Dr Barry J Marshall

Aileen Corrieri stopped writing her food blog, Hungry Aileen, a few years ago after she learned she had H pylori. Like Weiss, even after treatment, she was afraid to return to her former diet.

“I just spend a lot of time on TikTok and YouTube watching cooking videos,” she says, “just to live through the visuals”. Corrieri says her doctors didn’t take her stomach troubles seriously: “They just told me, ‘Don’t eat acidic food, you are fine.’ I felt really alone in this.”

Despite all the research on H pylori, there are still some aspects of it that aren’t fully understood, Salama says, like the precise way in which H pylori leads to cancer.

Marshall, the Nobel winner, says that the bacteria’s origins were also unclear: “How did the human race become so universally infected?”

Some studies suggest that H pylori can be beneficial for the oesophagus or guard against asthma. But Marshall believes that people who have stomach problems and test positive for H pylori should opt for antibiotics.

I finished my course of antibiotics about a month ago. It was a painful 10 days in which I vomited while exercising, spent a full day nauseated on my back and constantly had a bitter, metallic taste in my mouth. In a few days I’ll see my doctor again and find out if the bacteria are gone.

I’ve eaten a few restaurant meals since, but it’s hard to tell whether my situation has changed. I have realised, though, how much I had normalised being uncomfortable.

I doubt my stomach aches will disappear entirely. But if they do return with a vengeance, maybe next time I won’t wait 30 years to see a doctor. — This article originally appeared in The New York Times