Educated people sometimes get mired in their own dogmatic thinking.
Despite finding bacteria in tissue samples taken from the stomachs of people with ulcers, generations of physicians doggedly clung to the belief that most ulcers resulted from stress and poor dietary habits, and they exhorted their patients to make lifestyle changes that would supposedly cure them.
Even though scientists acknowledged that the bacteria found in specimens from different people all looked the same, they presumed these microorganisms resulted from contamination. After all, they claimed, the stomach’s interior is essentially a sterile environment, made so by high concentrations of hydrochloric acid that kill bacteria.
Australian Physicians Challenge the Establishment
In 1982, Dr. Robert Warren, a pathologist from Perth, Australia, changed the paradigm. Like his counterparts in other parts of the world, he observed that about half of the stomach biopsies he examined were colonized by a small, curved bacterium.
Unlike other scientists, however, Warren noticed that whenever the bacteria were present, they were accompanied by an inflammatory response in the surrounding stomach tissue. He shared his findings with Dr. Barry Marshall, a young clinical fellow who was as intrigued by this discovery as Warren. Together, they scrutinized dozens of biopsies to confirm their suspicions that the bacterium was not a contaminant, but was, indeed, a disease-causing organism.
Following several attempts, Warren and Marshall finally cultivated the previously unidentified organism (now known as Helicobacter pylori) and proposed to the scientific world that it was involved in the genesis of gastritis, gastric ulcers, and duodenal ulcers.
Proof of Helicobacter Pylori’s Role Required Extraordinary Measures
The notion that a bacterium could cause any ulcers, let alone most of them, was not easy to sell to the medical establishment. Scientists and physicians demand evidence – usually volumes of it – before they change established philosophies, even when those philosophies have no basis in fact.
Warren and Marshall sought an animal model to test their hypothesis, but they could not find one that faithfully reproduced the environment of the human gastrointestinal tract. Frustrated with the lack of a reliable animal model and the resistance of the scientific world, Marshall embarked on a course that is not often traveled by modern scientists: He infected himself with the newly-discovered bacteria. Soon thereafter, he became ill, developed stomach ulcers, and eventually cultured H. pylori from his own ulcers, thus proving a causal relationship between the organism and the disease.
In 2005, Warren and Marshall were awarded the Nobel Prize in Medicine for their work.
Just How Important is H. Pylori in the Grand Scheme?
The U.S. Centers for Disease Control and Prevention estimates that approximately two-thirds of the world’s population harbors H. pylori in their gastrointestinal tracts. Since the organism is spread through close personal contact and contaminated food and water, infection is more common in developing countries.
Although the majority of people infected with H. pylori will not become clinically ill, the organism always causes inflammation in the stomach lining, and up to 20 percent of infected individuals will develop ulcers.
Furthermore, H. pylori infection is now the most important risk factor for stomach cancer, and it is linked to intestinal lymphoma and possibly even to pancreatic cancer and cardiovascular disease.
That all adds up to a fairly significant global presence for a bacterium that wasn’t even supposed to exist.
Sources
- National Cancer Institute: H. Pylori and Cancer
- Press Release: The Nobel Prize in Physiology or Medicine 2005: Barry J. Marshall, MD; J. Robin Warren, MD
Stephen Allen Christensen - Dr. Steve Christensen's writing has appeared in magazines, professional journals, poetry anthologies, and children's books since 1976.
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