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Giving yourself an ulcer just to prove a point.

There is a book I am currently reading on great and good ideas. One of the numerous example given is that of Dr Barry Marshall.  The Australian doctor turned the treatment of peptic ulcers on its head and was subsequently awarded a Nobel Prize in Physiology and Medicine. This doctor noticed that most of the patient with ulcers had a stomach bug Helicobacter pylori. It lives in the stomach and is shaped like a corkscrew and is able to burrow into the mucus lining of the stomach and hence avoid the acidic environment.


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The bacteria H. Pylori also uses chemotaxis to neutralize the acid producing a large amount of urease which breaks down the urea present in the stomach to form carbon dioxide and ammonia. These neutralise the acid.



After Dr Marshall produces his report in Australia he was ridiculed by the established doctors and scientists. Most of them did not believe that any bacteria would survive in the hostile acidic environment of the stomach. The stomach does produce Hydrochloric acid which is one of the corrosive acids known. But despite this, he was able to get money for research and he teamed up with a Pathologist Robin Warren who brought it to the attention of the doctor and they began taking samples. From all the samples they took it to turn out negative. At the same time, there was an outbreak of an infection in another part of the hospital. The reason why the stomach biopsies came back as negative initially was that they left them for only two days and got rid of the samples. If was later found out the H. pylori is a slow-growing bacteria. Now, because they were overwhelmed with work they could not get to the samples till much later and they found that all the samples had H. pylori.

In 1983 they submitted their findings so far to the Gastroenterological Society of Australia, but the reviewers turned their paper down, rating it in the bottom 10% of those they received in 1983. Unable to make his case in studies with lab mice (because H. pylori affect only primates) and prohibited from experimenting on people, Marshall grew desperate. Finally, he ran an experiment on the only human patient he could ethically recruit. He drank a broth of the bacteria in 1984, and later he developed gastritis and his breath began to stink and he was vomiting. He then biopsied his own gut and confirmed he had H. pylori after which he started himself on antibiotics. Marshall did not develop antibodies to H. pylori, suggesting that innate immunity can sometimes eradicate acute  H. pylori infection. Marshall's illness and recovery, based on a culture of organisms extracted from a patient, fulfilled Koch's postulates for H. pylori and gastritis, but not for peptic ulcer. This experiment was published in 1985 in the Medical Journal of Australia

He did spend many years to convince the medical establishment of their work.
Big Pharm was not interested because they were making millions selling antacids and other drugs. With doctors believing that most ulcers were due to stress and using operations to treat chronic duodenal ulcers and antacids with H2 blockers. The message finally got out when magazines got interested in the story and he became a celebrity overnight.


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