Ulcers And The Helicobacter Pylori Revolution
Thanks to the discovery of Helicobacter pylori, most individuals with duodenal and gastric ulcers can be treated with one of several multidrug regimens.
Even as late as the 1980s, common knowledge held that ulcers were caused by stress. This view was so entrenched that when Barry Marshall, a young Australian physician, put forth a radical new idea — that most ulcers were caused by a simple, whirlygig-shaped bacterium — the medical establishment ridiculed him. Few believed that bacteria could survive in the inhospitable, acid-soaked environment of the stomach.
The notion was dismissed as absurd until Marshall, fed up with the nay saying and convinced that the bacterium — which he named Helicobacter pylori after the helicopter shape — was to blame, tested his theory on himself. He swallowed a walloping dose of H. pylori, got sick and — just as he had expected — developed an ulcer. Then he cured himself with a regimen of antibiotics and bismuth (found in Pepto-Bismol) and changed the course of ulcer treatment worldwide.
Now, thanks to Marshall, most individuals with duodenal and gastric ulcers can be treated effectively using one of several multidrug regimens. Treatment usually involves an acid blocker (proton pump inhibitors like omeprazole or lansoprazole; or H2 blockers like ranitidine) or bismuth or a combination of the two. In addition, the patient also takes two or three antibiotics, commonly a combination of amoxicillin, clarithromycin, metronidazole or tetracycline.
Be aware, however, that H. pylori cannot be eradicated in a few days, and some strains are more resistant to treatment than others. To avoid a chronic or recurrent infection, the patient must take every last pill of the drugs prescribed.
Scientists now believe that half of the world's population is colonized with H. pylori and that infection with this bacteria probably happens in childhood. However, why ulcers eventually develop in only some of these people remains unknown. It has been suggested that environmental factors may play a part. Some studies have shown that regular use of nonsteroidal anti-inflammatory analgesics, smoking and — yes — stress are significant predictors for development and delayed healing of ulcers.