Nobel Laureate Risks Death to Prove Link Between Ulcers and Bacteria

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Dr. Barry Marshall is an Australian physician who won the 2005 Nobel Prize in Physiology or Medicine with J. Robin Warren for proving that most peptic ulcers are caused by a bacteria called bacterium Helicobacter pylori (H. pylori) which led to breakthroughs in the study and treatment of stomach cancers.

Determination Led to Break the Mythology of a Disease

Before the 20th century, the ulcer was not a respectable disease. “You’re under a lot of stress,” doctors would say. However, Dr. Barry Marshall had a different theory: that ulcers are in fact caused by a bacteria infestation, not stress, but no one believed him. It wasn’t until he risked his life by drinking broth containing bacteria Helicobacter pylori that he was able to show that his hypothesis was correct.

Dr. Barry Marshall was born in 1951 in Kalgoorlie, a gold rush town in Western Australia. Being interested in both math and science—but finding his math skills insufficient to study electrical engineering, Dr. Marshall explained, “I chose medical school as an alternative which was at least as interesting, and which did not require daily exposure to calculus!”

While doing his fifth year in medicine at the University of Western Australia in Perth, Dr. Marshall met his wife Adrienne, a psychology student at the time. Dr. Marshall then moved to Royal Perth Hospital to gain experience in cardiology, the second half of his rotation leading him to the gastroenterology program.

It was here, in 1979, where he met Dr. Robin Warren, the man with whom he would go on to share a Nobel Prize.

A Groundbreaking Observation

Dr. Robin Warren is a doctor of pathology who was then working at the Royal Perth Hospital, collecting bacteria samples from patients complaining of stomach pain. Looking for a project to get involved with, Dr. Marshall volunteered to follow-up with these patients. He was particularly interested in one patient on the list, a woman who had been to his ward before, complaining of horrible stomach pains but with no diagnosis. In desperation, they had sent her to a psychiatrist who went on to prescribe her antidepressants.

But the only thing coming up on her biopsy were clusters of bacteria in a reddened stomach.

A Great Piece of Luck Followed by a Desperate Act

Undeterred, Dr. Marshall went on to conduct work at the Fremantle Hospital in the years surrounding 1982. It was here that he observed very quickly the bacteria he found in the stomach’s of patients at Royal Perth Hospital were also present in patients here. What he describes as a “great piece of luck” arose in early 1983 when a grant that allowed Dr. Marshall to travel to England where he met Dr. Martin Skirrow. It was only a few days after his arrival that he confirmed that H. pylori was indeed present in British ulcer patients as well. These results began to spring up worldwide, further supporting Dr. Marshall’s claim that there was something more than stress causing gastric ulcers.

1984 was a difficult year for Dr. Marshall. He was having zero success with infecting a lab animal with this bacteria. Due to this failure, his work was being rejected by fellow scientists and he couldn’t get a paper published. Turns out, only primates are affected by this specific bacteria, and he couldn’t ethically test an infection on a human, so Dr. Marshall decided to test it on himself.

“I swizzled the organisms around in a cloudy broth and drank it,” he describes. After five days, he would wake up every morning needing to vomit. He adds, “after 10 days I had an endoscopy that showed the bacteria were everywhere. There was all this inflammation, and gastritis had developed.” He treated himself of the infection with antibiotics, thus proving his theory: that H. pylori do indeed cause gastric ulcers.

His and Dr. Warren’s research also supported the idea that H. pylori is linked to over 60 percent of all stomach cancer cases, a malignancy that is now almost eradicated from the Western world thanks to the discoveries made by Dr. Marshall and others.

Since then, Dr. Marshall has worked with countless collaborators, developing a diagnostic breath test for the ulcer-causing bacteria. “Reliable, cheap and available diagnostics are just as important in medicine as treatments”, he says.

After winning the Nobel Prize in Medicine or Physiology in 2005, Dr. Marshall states, “One of the truly great things about winning the Nobel Prize in 2005 was that I was living and working back home. I got to share it and celebrate with those who had been involved in the initial work at Royal Perth and Fremantle Hospital.”

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