Advances in our understanding of stomach ulcers represents a fascinating evolution in scientific thinking as well as a unique case study on a scientist who experimented on himself. We now know that infections are a primary cause of these ulcers and can be treated with antibiotics, an idea once considered unbelievable.

In their more serious forms, ulcers can have numerous concerning complications including severe intestinal bleeding, blockage of the intestines, and even perforation, which is a full thickness tear of the stomach or small bowel that mandates surgery. HP itself is instrumental in the development of forms of gastric cancer. Fortunately, with the advent of powerful antacids such as omeprazole and the discovery of H. Pylori, some of these complications are not as common as they once were.

If you have access to the Journal of the American Medical Association (JAMA), such as through a university or library, read this insightful interview with Dr. Marshall on the 35th anniversary of his initial identification and culture of H. Pylori in a patient with ulcer disease.

The term stress ulcer does exist but refers not emotional challenges but rather to the presence of severe infection or medical illness such as in patients in intensive care units. The strain on the human body resulting from these problems can prompt severe ulcer disease. As such, patients are often prophylactically put on antacid therapy to help reduce their occurrence though some have questioned if these medications are overused.

H. Pylori has a nuanced effect on other elements of intestinal health. Symptoms of ulcers can overlap with those of gastro-esophageal reflux disease, or GERD. This has led to the widespread practice of routinely treating GERD patients with antibiotics if they have evidence of Helicobacter Pylori. However, we now know that if H. Pylori resides in some parts of the stomach but not others, it may relieve complaints of GERD. The implications of this concept on treatment regimens are still being investigated.
In addition, some have argued that overtreatment of Helicobacter Pylori has contributed, in part, to shifts in our gut microbiome that may have complicated and nuanced effects on our well-being. The microbiome refers to the totality of bacteria, primarily in our gut, that is essentially for proper digestion, nutrient absorption and maintenance of overall health. Rates of antibiotic resistance through overuse in our environment, however, have made it harder in turn to treat H. Pylori effectively. For a fascinating TED talk on the microbiome, click here.

For more information about ulcers, read this recent article in the New York Times about one reporter’s personal journey through the ordeal of suffering from an ulcer as well as clearing some of the misconceptions she has had about them: 6 things I learned about ulcers.

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