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Infection Control & Patient Safety

Ulcer Cause Is Bacterium Not Spicy Foods – Bring on the Hot Wings!

Published January 31, 2012 7:20 AM by Linda Jones

ADVANCE welcomes the newest Insight blogger, Pam Strohmeyer, RN. She is a clinical research associate at Welch Allyn in Beaverton, OR. She has nearly 15 years of experience as a staff nurse and charge nurse in various ICU settings. In addition to her nursing background, she has a BS in biology and is currently pursuing an MS in clinical research administration at The George Washington University in Washington, DC. Prior to joining Welch Allyn, she conducted clinical research in medical imaging, co-authoring several papers and abstracts on the topics of nuclear medicine and positron emission tomography (PET). 

Would you drink a beaker full of potentially infectious bacteria to prove a point? Dr. Barry Marshall did, and in the process, he changed the way modern medicine looks at peptic ulcer disease. He also won a Nobel Prize for his efforts---not bad for a day's work (however icky).

In the 1980s, Marshall and his partner, Robin Warren, proposed that stomach ulcers were caused by Helicobacter pylori (H. pylori). This went against the conventional wisdom of the day, which held that diets and lifestyles were to blame. To test his hypothesis, Marshall drank some of his bacterial culture, and he promptly developed gastritis. Marshall and Warren's discovery meant that the previous suspects --- spicy foods and emotional stress --- were officially off the hook. This opened the door to new diagnostic tests and antibiotic treatment regimens for peptic ulcer disease. It also introduced the possibility of a future vaccine against gastric ulcers and stomach cancer.

Over half of the world's population may already be colonized with H. pylori. Scientists aren't sure why only some of the people who harbor the bacterium go on to develop ulcers. But for those who do, the effects can be painful and even life-threatening. Therefore, the ability to treat the cause, and not just the symptoms, has been a huge step forward.

But while antibiotic therapy has a better track record against ulcers than those old-fashioned antacids and bland diets had, many ulcers still recur after treatment. That's because H. pylori is a tough bug. The very fact that it's able to survive in the harsh, acidic environment of the stomach makes it difficult to eradicate. It burrows into the gastric lining where it's hard to reach, and it uses urease to break down the proteins we eat to make an ammonia shield for itself against the stomach's hydrochloric acid. Sometimes several courses of antibiotics are needed to resolve the infection.

As a result, an ounce of prevention may be worth a pound of cure. Unfortunately, H. pylori's mode of transmission is still poorly understood. It may spread through direct contact, or it may be a food-borne pathogen. Either way, good hand hygiene is essential for prevention, as is thoroughly washing and cooking your food.

And whatever you do, don't drink on the job...especially from a beaker.

posted by Linda Jones

1 comments

Sorry you had the H proyli too!  Good to know that I'm now more susceptible, too.  My dad has been treated for it 3 times, so it does make sense.  Thanks!!

Larry Larry, OxQQWxvxaKr - gjupvowfg, xjGReBDNtsyEJlrb February 20, 2012 9:35 AM
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    Occupation: Infection Control Professionals
    Setting: Welch Allyn; St. Luke’s Hospital (Smith)
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