I love stories about quacks who become prophets. Medical breakthroughs are often made by doctors who were first ridiculed by their peers. In 1983, Barry Marshall and John Warren presented a paper to the Australian Gastroenterological Society claiming that stomach ulcers are caused by infection. They never finished their presentation because they were laughed off the stage. Barry Marshall became so upset that he swallowed a vial of the bacteria taken from a patient who had stomach ulcers, went into shock and almost died. He had to be hospitalized and was saved by massive doses of intravenous antibiotics.
Acid Unlikely to Cause Stomach Ulcers
The prevailing theory at that time was that stomach acids digest stomach linings to cause ulcers, and treatment was to put a tube down a person’s nose and into his stomach and pour cream down the tube every 30 minutes. This didn’t cure ulcers, but 96 ounces of cream per day can cause a heart attack, and we now know that eating cream causes the stomach to produce ever more acid.
Ignored by Their Fellow Physicians
Other doctors tried and failed to convince the medical profession to treat stomach ulcers with antibiotics:
• In 1940, Dr. Frank D. Gorham of St. Louis said that he had found that intramuscular injections of bismuth helped to heal ulcers by killing germs. Also in 1940, Dr. A. Stone Freedberg of Harvard found curved bacteria, now called Helicobacter pylori, in the stomachs of ulcer patients in Boston. However, his chief of service told him to stop fooling with stomach diseases and stick to his specialty of cardiology. He became a leading heart researcher instead of the person who found the cure for stomach ulcers.
• In 1946, Dr. Constance Guion at New York Hospital presented a paper on how she treated stomach ulcers with the antibiotic chlortetracycline. Her fellow physicians at the famous Cornell Medical School criticized her so severely that she abandoned her idea of prescribing antibiotics for ulcers.
• In the 1950s, John Lykudis, a Greek physician practicing in a small town, developed a bleeding ulcer and cured himself with antibiotics. Since antibiotics worked for him, he decided to try them on his patients and presented reports of his successes to professors at several Greek medical schools. His colleagues were jealous because people from all over the world came to his small town to have him treat their stomach ulcers. Lykudis knew that he was right and the rest of the world was wrong, so he went to the Greek Minister of Health and the prime minister. They referred him to the chairmen of the department of medicine at Athens Medical School, who treated him as a nut. In 1956, he submitted a paper to the Journal of the American Medical Association and received a rejection letter that stated, “It does not seem appropriate for our journal.” He died in 1980, still viewed as a quack.
Vindication At Last
Three years after Lykudis’s death, Barry Marshall presented his groundbreaking paper about Helicobacter pylori and stomach ulcers, but it took more than ten years for his theory to be confirmed by other researchers. Today, Barry Marshall has the Nobel Prize in Medicine for discovering that stomach ulcers are caused by bacteria and are cured by antibiotics. He is now revered worldwide as the person who found the cure for stomach ulcers (Lancet, November 6, 1999: 1634). More on Helicobacter pylori
Lessons from Barry Marshall’s Experience
All new treatments in medicine should be met with some degree of skepticism until there is enough data to prove that that treatment really works. Doctors used to:
• take out appendices without hesitation, until they learned that the appendix replenishes healthful colon bacteria after you have taken antibiotics
• take out tonsils and adenoids without hesitation, until they learned that they can help to protect you from throat infections
• prescribe addicting drugs like codeine to treat coughs in children, until they learned that they cure nothing and can cause addiction
• over-prescribe electric shock therapy to treat depression, until they learned that it can cause permanent brain damage
• over-prescribe diet pills to treat overweight, until they learned that they cure nothing without major permanent lifestyle changes, and have lots of side effects
• cut into the brain to disconnect parts (lobotomy) to treat mental and emotional diseases, until they learned that it can cause permanent brain damage
• put stents in heart arteries of people who do not have blockage, until they learned that stents can increase long-term chances for suffering clots and heart attacks
• prescribe long-term bed rest after a heart attack, until they learned that lack of exercise increases chances for suffering another heart attack
• and so forth.
My Bout of Helicobacter Pylori
I have never had any stomach problems until February 2023, when at age 87, I started to burp and belch and then developed progressively more severe belly pain. My stool test for Helicobacter pylori came back strongly positive, so I took antibiotics (metronidazole and doxycycline) for a week and my symptoms disappeared.
About 50 percent of North American adults carry Helicobacter pylori, and treatment is usually not needed unless you have symptoms (Malays J Med Sci, 2015 Sep;22(5):70-75). If you should ever develop belching, burping and burning in your stomach, ask your doctor to order a DNA stool test for Helicobacter pylori. This test is quicker and is as dependable in diagnosing the infection as standard stool cultures or the more invasive tests. However, it will not rule out stomach cancer, which can develop from long-term infection with Helicobacter pylori.
Barry Marshall
September 30, 1951 – present
