Didn’t you think that stomach ulcers were always caused by stress? The prevailing view for many decades was that ulcers were caused by stress and excess stomach acid.
But in the 1980s, an Australian internist, Dr. Barry Marshall, came up with a new theory and he was committed to testing it out. Since his research had to be conducted on humans and with the challenges of doing this type of experimentation, he decided to test the one subject available and willing – himself. Marshall deliberately swallowed a broth containing helicobacter pylori bacteria (also known as H pylori), and five days later became ill with abdominal pain and vomiting. A scope test showed the bacteria had spread throughout his stomach causing severe inflammation.
He was convinced H pylori bacteria was the underlying cause of stomach ulcers. This bacteria has been estimated to be present in about 50% of the world’s population although not everyone who carries this bacteria in their body becomes ill from it.
Convincing Marshall’s medical colleagues that a bacteria was the cause of most ulcers was challenging. It wasn’t until about 10 years after his experiment on himself that his theory gained widespread acceptance. He won the Nobel Prize for Medicine in 2005, along with his colleague, Dr. Robin Warren, because this discovery had so much impact in changing the way ulcers are treated.
It is now known that this bacteria is the most common chronic bacterial infection in humans, and has an association with the following G.I. conditions: peptic ulcer disease (stomach and small intestine ulcers), chronic gastritis (inflammation of the stomach), cancer of the stomach and lymphoma of the stomach. Current thinking is that ulcers are caused by H pylori in most cases, though use of anti-inflammatory medications can also cause ulcers in a smaller percentage of cases.
Ulcers can cause a variety of symptoms, including abdominal pain, nausea, vomiting, poor appetite and dark colored stools. Ulcers have been described in medical writings for many centuries. In the early 20th century, there was an autopsy done of a mummy from China 167 B.C.E. that may have been the first recognized case of an ulcer. However, it wasn’t until the late 19th century that ulcers became identified as a common diagnosis. With the advent of X-ray imaging and endoscopy in the 20th century, the diagnosis can now be made with more certainty. In addition, with endoscopy, the presence of H pylori infection as the cause of ulcers can be confirmed.
The good news is the treatment of an H. Pylori infection can cure ulcers and prevent ulcers from recurring. A cocktail of medications is usually recommended to treat this infection, which includes antibiotics and acid blocking medications, which are usually extremely effective.
Dr. Mark Roth writes about internal medicine for the Cleveland Jewish News. He is an internal medicine physician with University Hospitals.