Barb Handy shares why she always starts with stomach health, like low acid and H. pylori, before treating SIBO and how it’s helped clients get better results with fewer treatments.
Introduction and Personal Journey into Gut Health
Josef Kreitmayer:
Welcome to another amazing session here at the Reflux Summit. We are welcoming today, Barb Handy. Barb, welcome.
Barb Handy:
Thank you.
Josef Kreitmayer:
It’s amazing to have you. May I introduce you to the audience?
Barb Handy:
Of course.
Josef Kreitmayer:
Barb Handy is a certified nutritional practitioner and holistic nutritionist specializing in chronic H. pylori, SIBO, reflux, and IBS. A former gut health patient herself, she has over seven years of experience helping others achieve lasting relief through root cause functional medicine. Barb developed an approach called the Digestive Reset Method, which combines advanced testing with science-backed natural protocols to restore digestive health. Originally, she focused on SIBO, but over time, she became a sought-after expert in addressing persistent reflux and heartburn by targeting underlying causes like low stomach acid and microbial imbalances. She’s based in Canada and runs a virtual clinic serving clients across North America, the UK, Europe, and Australia.
Wonderful to have you here, Barb. Let’s dive into your experience, your protocol, and what you do.
Barb Handy:
Yeah, very excited to do that.
Transition from SIBO Focus to Reflux
Josef Kreitmayer:
You originally focused on SIBO but transitioned toward reflux. How did that happen?
Barb Handy:
When I started, my mission was to raise awareness about SIBO because that was my own gut health journey. While working with clients, I began to unravel the root causes of SIBO, which is crucial for addressing it. I noticed a pattern—most clients who came for SIBO, around eight out of ten, also had upper GI issues like heartburn and reflux.
I run the GI-MAP stool test in my clinic, and I keep seeing H. pylori show up frequently. I also realized that clients coming for heartburn or reflux often had SIBO too. It evolved naturally—while focusing on SIBO, I saw that SIBO is often a symptom, not the root issue.
Patterns emerged: clients with SIBO often had low stomach acid and H. pylori, and they reported symptoms like bloating, altered bowels, and food intolerances—yet also complained of feeling like they couldn’t digest food, reflux, heartburn, and stomach pain.
It became clear that low stomach acid was a major factor. Very few clients came in with just SIBO or IBS without also having upper GI issues.
Root Causes: SIBO, Low Stomach Acid, and H. pylori
Josef Kreitmayer:
So, when you say SIBO isn’t the root cause, what’s driving it? Is it low stomach acid, or are there multiple factors?
Barb Handy:
There are several factors. Clinically, I see food poisoning as the leading cause of SIBO, followed by abdominal adhesions, then low digestive capacity, meaning not enough stomach acid or digestive enzymes.
Some debate whether low stomach acid contributes to SIBO, but studies show that long-term PPI use increases the risk of SIBO. In my practice, I definitely see a correlation. So when someone comes to me with SIBO-like symptoms—bloating, IBS—I always address the stomach first. If H. pylori is present or stomach acid is low, we tackle that before focusing on SIBO.
This approach has improved outcomes: instead of multiple, repeated SIBO treatments, we often resolve it within one or two rounds. It’s about sequencing—doing things in the right order.
Stomach Acid, Digestive Function, and the Role of Bile
Josef Kreitmayer:
You mentioned that proper digestion requires more than just stomach acid. Can you explain the connection between stomach acid, bile, and enzymes?
Barb Handy:
Absolutely. Stomach acid is the first line of defense—it kills pathogens in food, like bacteria, parasites, and fungi. If you have enough stomach acid and no H. pylori suppressing it, you’re protected.
Stomach acid also triggers bile production from the liver. Bile is essential for breaking down dietary fats and keeping the small intestine clear of bacterial overgrowth—it’s a natural antimicrobial.
Low stomach acid often coincides with poor liver function. I see this on GI-MAP tests—clients show signs of sluggish liver detoxification and poor bile quality, which leads to bacterial, parasite, or fungal overgrowth.
Stomach acid also signals the pancreas to release digestive enzymes. If that signal is weak, enzyme output is low, food isn’t fully broken down, and fermentation happens in the gut, fueling SIBO and other issues.
The Bigger Picture: Holistic Digestion
Josef Kreitmayer:
It seems like the pancreas and liver are underestimated. People tend to focus on the stomach and upper GI issues. Do you agree?
Barb Handy:
Yes, absolutely. You can’t isolate one part of the digestive system. It’s a whole process—from the mouth to the colon. If you don’t chew food well, even with good stomach acid, digestion is compromised.
The nervous system plays a huge role. If you’re stressed, digestion shuts down—stomach acid drops, enzyme production slows, and motility decreases. So I help clients understand the full digestive journey. When people grasp the “why,” they’re more motivated to make changes, like slowing down, chewing properly, managing stress, and creating an optimal environment for digestion.
Modern Lifestyle, Stress, and Gut Dysfunction
Josef Kreitmayer:
Why do these imbalances happen? Why does the liver stop producing enough bile, or do enzymes decline?
Barb Handy:
It’s a modern lifestyle issue. We’re disconnected from how we’re meant to function. Constant busyness, stress, and eating on the go interfere with digestion. People eat at their desks, in front of the TV, rushing through meals.
Your body needs to feel safe and calm to digest properly. If you’re multitasking or watching TV while eating, your body perceives a threat and digestion slows, leading to bloating, gas, constipation, diarrhea, or reflux.
We also don’t chew properly—many people swallow food whole, which reduces the surface area for enzymes and acids to act. Carbohydrate digestion, for example, starts in the mouth. Poor chewing leads to fermentation in the gut, contributing to reflux, bloating, and heartburn.
Common Symptoms and Root Causes in Barb’s Practice
Josef Kreitmayer:
What symptom patterns do you see in clients who come to you?
Barb Handy:
There are three main groups. First, those with bloating, constipation, limited diets, and IBS diagnoses often don’t know they have SIBO until we test.
Second, those who’ve been through the system, tried different protocols, and still struggle with SIBO.
Third, people with reflux, GERD, or gastritis—upper GI symptoms—but when we dig deeper, they also have bloating, constipation, and other gut issues. They may not even realize they’re bloated because they’ve lived that way for so long.
Most of my reflux clients also have SIBO, Candida, or parasites. It’s rarely just reflux.
Reflux Types, SIBO, and Symptom Correlations
Josef Kreitmayer:
Do you see SIBO more connected to classic GERD and heartburn or LPR-type reflux?
Barb Handy:
It’s mixed. Some clients notice that bloating or constipation makes reflux worse, but not everyone connects the dots. LPR is tricky—people may have nausea or silent reflux without classic heartburn.
The GI-MAP test helps reveal patterns, like low stomach acid or H. pylori. It’s not always a direct correlation—sometimes reflux is just from bloating pushing upward, like in pregnancy. The test helps determine whether reflux is a symptom or a structural consequence.
The GI-MAP Test: Insights and Patterns
Josef Kreitmayer:
Let’s dive into the GI-MAP test. What insights do you get from it? What patterns do you look for?
Barb Handy:
The GI-MAP is incredibly valuable for upper and lower GI issues, but it doesn’t diagnose SIBO—that requires a breath test. For reflux cases, I focus first on H. pylori markers—whether they’re elevated or just present. If they are, and the symptoms match, we treat them.
I also check for opportunistic bacteria—certain strains, like Staphylococcus and Streptococcus, often show up when stomach acid is low or H. pylori is present. These bacteria thrive in a higher pH environment, so they’re a red flag.
Beyond that, I look for overgrowths like Candida and parasites, and then the digestive health markers—especially steatocrit and elastase. Steatocrit shows fat in the stool, which might suggest issues with bile flow from the liver and gallbladder, while low elastase indicates poor pancreatic enzyme production.
It’s about connecting the dots—symptoms, test results, and patterns. Sometimes people with H. pylori don’t have classic reflux or heartburn—they may have nausea, stomach pain, or diarrhea. So, it’s not always a textbook.
Tailoring Protocols: A Case-by-Case Approach
Josef Kreitmayer:
Once you get these insights from the GI-MAP, how do you tailor a protocol?
Barb Handy:
It’s entirely based on the individual. I look at the microbes, the digestive markers, and the client’s symptoms. I never take a “one size fits all” approach—there’s no cookie-cutter protocol.
For example, if someone has SIBO and H. pylori, we don’t treat both at the same time. We handle upper GI issues first—stomach acid, H. pylori, digestive support—then move to SIBO and lower gut issues. If Candida is present, we address that too.
The order of operations is key—upper GI first, then SIBO, then microbiome rebuilding. We might also need to heal the stomach lining, support bile production, or reintroduce diversity through diet and targeted probiotics.
I don’t use generic probiotics for everyone—sometimes people don’t need them. We focus on prebiotics, polyphenols, and the right strains based on the test. It’s highly individualized.
Testing Strategy: When and How to Test
Josef Kreitmayer:
When do you decide whether a client needs testing like the SIBO breath test or GI-MAP?
Barb Handy:
Previously, I required both tests before the first session—SIBO breath and GI-MAP. It saved time because we had answers from the start.
Now, I’m more flexible. Many clients already have testing from other practitioners. If not, I recommend testing before our first deep dive—it saves time and money in the long run.
These tests are readily available in North America and fairly accessible in the UK, Europe, and Australia. If someone can’t get them, I can still work symptomatically based on experience, but I always encourage testing—it eliminates guesswork and helps build a precise protocol.
The Protocol Process: Step-by-Step Healing
Josef Kreitmayer:
Once you have the test results, how do you guide clients through the healing process?
Barb Handy:
We start by addressing the upper GI—stomach acid, H. pylori, GERD, and gastritis. We optimize digestion with herbs, supplements, and lifestyle changes.
Then we move to SIBO, Candida, or other lower GI issues. Once that’s done, we focus on long-term healing—supporting the microbiome, reducing inflammation, and rebuilding the gut lining.
Every phase is tailored—some clients need esophageal and stomach lining healing, others need to rebuild their microbiome. Some might not need probiotics but benefit from more plant diversity and polyphenols. It’s never a copy-paste protocol.
Intestinal Methanogen Overgrowth (IMO) and SIBO Complexity
Josef Kreitmayer:
Do you also see IMO—intestinal methanogen overgrowth—in your practice?
Barb Handy:
Yes, all the time. IMO is common, and it’s different from SIBO because it involves archaea, not bacteria. It can be present throughout the small and large intestine.
IMO is tough to treat—it burrows into the intestinal lining. While new drugs are in development, for now, we manage with antimicrobials and herbal protocols.
If someone has IMO, they also have hydrogen SIBO—methane requires hydrogen as fuel. So we always treat both together. Some probiotics, like certain strains, can help in eradication, too.
It’s crucial to work with a practitioner who understands these nuances—SIBO and IMO are complex, and proper sequencing and dosing make a big difference.
Testing Limitations and the Human Element
Josef Kreitmayer:
It’s so important to have a combined breath test—hydrogen and methane—right? Otherwise, you might miss half the picture.
Barb Handy:
Absolutely. Some places only offer hydrogen testing, which is incomplete. You really need both hydrogen and methane, ideally hydrogen sulfide too, though that’s harder to access.
In Europe, access can be limited—I’ve had clients go to different countries for testing. If testing isn’t possible, we rely on symptoms.
But remember, testing is a tool. It guides us, but we treat the person, not just the test. For example, I’ve had clients with a positive SIBO test but no symptoms—so we don’t treat the test, we treat based on what the client is experiencing.
The Correlation Between Stomach Acid, H. pylori, and SIBO
Josef Kreitmayer:
Do you see a correlation between low stomach acid, H. pylori, and SIBO? Or are they independent?
Barb Handy:
I see a strong correlation. Some doctors disagree, but in my practice, it’s clear—low stomach acid contributes to bacterial overgrowth, including SIBO and Candida.
SIBO is bacteria in the wrong place—normally in the large bowel, but now in the small bowel. If stomach acid is low, it doesn’t kill bacteria coming in, so H. pylori and other overgrowths can develop.
H. pylori is everywhere—58% of the world has it. It’s not inherently bad, but it can become an infection when overgrown, especially in people with low stomach acid due to stress, poor diet, or nutrient deficiencies.
Low stomach acid affects bile production too, and bile is critical for clearing bacteria, fungi, and parasites. It’s all connected.
Addressing Lifestyle, Stress, and Nutrients
Josef Kreitmayer:
So the two main factors for stomach acid seem to be lifestyle and nutrients?
Barb Handy:
Exactly. Stress is a huge factor—we look at lifestyle, family dynamics, and work demands. Chronic stress suppresses stomach acid, and while I can’t tell someone to stop being stressed, we can support them—therapy, finding joy, creating space for themselves.
Nutrients are key too—whole foods, minerals, chewing well, not drinking too much liquid during meals, and deep breathing before eating.
Foundational habits matter. People often look for a magic pill, but the basics—how you eat, how you breathe, your mindset—are what make a difference. If necessary, I support with herbs or supplements, but you can’t out-supplement a poor diet or lifestyle.
Weaning Off Proton Pump Inhibitors (PPIs)
Josef Kreitmayer:
How do you help clients come off long-term PPIs?
Barb Handy:
It’s actually straightforward. Once you stop PPIs, the stomach usually starts producing acid again. The key is managing rebound symptoms—working with a practitioner to wean off slowly, usually over eight weeks, sometimes as little as three.
We also use supplements and herbs to soothe any rebound effects, and with the right strategy, people transition off without much trouble.
How to Work with Barb: Programs and Approach
Josef Kreitmayer:
If someone wants to work with you, how does it work?
Barb Handy:
People apply through my website, www.thedigestivehealthacademy.com. We start with an onboarding consultation to assess commitment and fit.
I offer two programs: a 16-week deep dive for complex cases—multiple issues like reflux, bloating, constipation—and an 8-week program for those wanting to start unpacking root causes. The programs focus on identifying and addressing root issues, not necessarily “fixing” everything in a set time, though some clients do resolve their issues within that window.
I designed these programs after realizing that one-off sessions don’t work. Programs provide accountability, support, and structured guidance. I’m there Monday through Friday to answer questions, make adjustments, and ensure clients stay on track. That’s why my success rate is so high.
I also offer single sessions for those who aren’t ready to commit, but the programs are where real transformation happens.
Final Advice: Work with a Specialist
Josef Kreitmayer:
Any final advice for the audience?
Barb Handy:
Yes—work with a practitioner who specializes in your condition. Don’t go to a generalist or someone who dabbles in everything. Specialists have the experience and understanding to help you effectively.
I’ve seen too many clients waste time and money with practitioners who don’t focus on gut health. Working with the right person is key to getting the best results in the shortest time.
Josef Kreitmayer:
Barb, thank you so much for sharing your insights. To the audience, you can find Barb’s contact information below this video. Barb, thank you for a wonderful conversation.
Barb Handy:
Thank you.
