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Barry Marshall and Robin Warren are two Australian researchers who won the 2005 Nobel Prize in Physiology and Medicine, for their work on helicobacter pylori and convincing physicians that it does cause stomach ulcers and stomach cancer and is treatable.

Prior to their work, many more people bled to death from stomach and duodenal ulcers and died from stomach cancer. An ulcer can erode into arteries that will bleed at a rate that we can't put blood in fast enough to keep up. In 1993 I once was yelling into the phone at 2 am in the VA ICU that I didn't care what machines were broken, I needed a blood count stat because my GI bleeder patient was throwing blood up everywhere.

He survived.

These two researchers spent over ten years writing and publishing scientific papers about helicobacter pylori and were pretty much pooh-poohed by the medical community. There were various problems along the way. One was that it was very difficult to culture. Someone was in a hurry one night to get to a child's birthday party, and left cultures out instead of throwing them out. It grew. They had it.

The second was that the medical communities didn't believe that an infection could cause ulcers. "To gastroenterologists, the concept of a germ causing ulcers was like saying that the Earth is flat." There also was a ton of money involved, in doing endoscopies and selling tagamet at $100 per month: "I had this discovery that could undermine a $3 billion industry, not just the drugs but the entire field of endoscopy." Dr. Marshall finally had an upper endoscopy, proving that he had no ulcers. He drank helicobacter pylori and started throwing up five days later. A second endoscopy showed gastritis and infection. They treated it. The infection cleared.

Still no one believed him, and it was actually articles in Reader's Digest and The National Enquirer that let patients learn about it. They put pressure on the medical community who said that the studies were not complete. Dr. Marshall pointed out that people were dying of stomach cancer and ulcers and that they needed a fast track. "And ultimately, the NIH and FDA did that. They fast-tracked a lot of this knowledge into the United States and said to the journals: “We can’t wait for you guys to conduct these wonderful, perfect studies. We’re going to move forward and get the news out.”

Learning that it took ten years of publications before physicians would listen is one of the things that makes me keep my ear to the ground about alternative medical treatments. Because mainstream MDs are not right all the time and historically are slow to change and adopt new treatments The changes over the last ten years in our understanding of opioids and the brain has certainly reinforced that.

And Dr. Marshall on unexplained diseases:

"Based on this experience, should we be taking a fresh look at other diseases that do not have well-understood causes?"

"Helicobacter made us realize that we can’t confidently rule out infectious causes for most diseases that are still unexplained. By the 1980s, infectious disease was considered a has-been specialty, and experts were saying everyone with an infectious disease could be cured by antibiotics. But what about when your kids were 2 years old? Every week they’d come home with a different virus. You didn’t know what the infections were. The kids had a fever for two days, they didn’t sleep, they were irritable, and then it was over. Well, you think it is over. It might be gone, but it has put a scar on their immune system. And when they grow up, they’ve developed colitis or Crohn’s disease or maybe eczema. There are hundreds of diseases like this, and no one knows the cause. It might be a germ, just one you can’t find."


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