Gastric tubes as vectors of Helicobacter pylori transmission

Abstract

Peptic ulcer was a rare disease before 1850. The prevalence of peptic ulcer increased gradually in persons born between 1870 and 1900. A similar decay in opposite direction of the prevalence occurred after the 1960–1970s. Although the pathogenesis of peptic ulcer is readily explained by the Helicobacter pylori infection, the bacterium occurred many thousands years ago and followed the migrations of human populations; consequently, its presence does not explain the increase in peptic ulcer prevalence. Gastric tubes for secretory testing were introduced from 1871 and their use was extended gradually in the then growing departments of gastroenterology, becoming a very popular, though unpleasant method. There is circumstantial evidence from the pre- H. pylori era that gastric/enteral infections could be transmitted though contaminated gastric tubes/electrodes. The author’s hypothesis is based on the temporary overlap of the increased peptic ulcer prevalence and the extensive use of gastric secretory testing. The use of contaminated gastric tubes in sick persons harbouring pathogenic strains of the bacterium could have led to the transmission of the infection by gastro-oral route to the patients’ ward-mates and on, to their family members: years later, new ulcer or dyspeptic patients may have come from such groups. The current decay in peptic ulcer prevalence could be due to the decreased use of secretory testing and implementation of rigorous disinfection rules.