Monday, October 3, 2005

pH or Hp - Dicoverers of the Link Between Helicobacter pylori and PUD Awarded the Nobel Prize for Medicine

Australians Barry J. Marshall and Robin Warren have won the 2005 Nobel Prize in physiology or medicine "for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease".

- See the original Dr. Marshal's web page (the Hp image used with permission)
- Listen to an interview with Barry J. Marshall
- Listen to an interview with J. Robin Warren

The widely accepted truth for a long time was that the main cause of peptic ulcer disease (PUD) was the increased acidity - pH.

Then two Australians discovered the bacterium which causes the ulcers and gave it the name Helicobacter pylori (Hp).

The Lancet was courageous enough to pubslish the landmark article in 1984.

The debate began - what is the cause of PUD - is it pH or Hp? It took 10 years for the medical community to accept the truth. Although the increased acidity plays a role in duodenal ulcers, adding treatment for the Hp infection dramatically improves cure rates.

Nobody believed the discoverers initially, one of them even swallowed an Hp isolate, became sick and was treated with antibiotics - all this in attempt to prove the causative relationship between Hp and PUD.

Now the Billroth surgical operation for PUD is almost forgotten because very few ulcers require surgery. Almost all of them are treated medically with the OAC combination or other alternatives. OAC stands for Omeprazole, Amoxicillin, and Clarithromycin.

Who could have believed in 1984 that the PUD was an infection? Only the two doctors who received the Nobel Prize for Medicine yesterday...

Diagnosis of Helicobacter pylori infection: 13C urea breath test or the stool antigen test as “test and treat strategy”. BMJ, 2012.

References:

Nobel for Medicine Goes to Australian Scientists - NPR. Listen to the story
Scientists Win Nobel for Bacterium-Ulcer Link - NPR. Listen to the story
Nobel prize is awarded to doctors who discovered H pylori - BMJ 10/05
Barry Marshall's web sites - 1 and 2
Australians win Nobel in medicine - CNN
H. pylori image courtesy of www.hpylori.com.au

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