Chapter 22 - Warren, Marshall, Helicobacter Pylori, Peptic Ulcers and Gastric Cancer

Abstract

Chronic peptic ulcer disease (CPUD) was a disease group with severe complications requiring long-term medical care, surgery in many cases, and death from perforation or hemorrhage, known as a major medical problem from antiquity until the late 20th century. In the 1970s, the discovery of histamine receptor (H2 receptor) was a breakthrough, identifying a principal factor in gastric acid secretion, which responded to treatment with H2 antagonists. This proved to be a safe and effective therapy for CPUD. However, in 1982, a new medical discovery of the cause of the condition was made by Drs. Robin Warren and Barry Marshall at the Royal Perth Hospital in Perth, Western Australia, offering the answer to the cause of CPUD and providing a simple and inexpensive antibiotic therapy cure and, jointly winning them the Nobel Prize in 2005. CPUD became curable, and emptied medical and surgical departments of CPUD patients for gastrectomies, vagotomies, and other procedures that previously filled these departments, as well as reducing death from severe complications of peptic ulcers including hemorrhage and perforation, and the incidence of cancer of the stomach. The causative relationship of treatable H pylori to CPUD, one of the commonest medical problems, and to gastric cancer and its prominence as the third leading cancer cause of death globally makes control and ultimate eradication of this infection a major public health challenge for the coming decades. This was one of the great breakthroughs in medicine and public health of the 20th century.