Category: A Victory!

How committed are you to your profession? If you are a Walmart greeter or work at Chick-fil-A, that might just mean being nice to people all the time so as to stay in character.

If you are a trial attorney, you might kick innocent babies or torture beagle puppies in your free time just to keep that edge. However, if you were a research physician at the Royal Perth Hospital specializing in gastroenterology in 1979, a truly serious level of commitment might take you to a whole new place.

The Guy

Barry Marshall was born in Kalgoorlie, Western Australia, in 1951. He was the eldest of four kids. His dad did a variety of things to make a living, and his mom was a nurse. When he came of age, Marshall attended the University of Western Australia School of Medicine.

While Registrar in Medicine at Royal Perth Hospital, Marshall and a fellow research physician, Dr. Robin Warren, began studying the gut microbiome.

Curiously, there are more bacteria in and on your body than there are cells. That means when you look at someone, there is actually more stuff that’s not them than is them. That applies to dirty farmers, adorable little infants, and even pretty girls. That’s kind of creepy if you let yourself think about it.

Drs. Marshall and Warren observed that a lot of people with gastritis, stomach ulcers and gastric cancer tended to have spiral bacteria in their stomachs.

Eventually, they cultured Helicobacter pylori and suspected that particular microscopic beastie to be the culprit. When they announced their suppositions, they were laughed out of the scientific circles.

Their paper on the subject, presented to the Gastroenterological Society of Australia, was rated in the bottom 10% of submissions in 1983. After all, everybody knew that gastric ulcers were caused by spicy foods and high-stress jobs. Marshall later said, “Everyone was against me, but I knew I was right.”

There was reason to be skeptical. The first 30 of 100 gastric samples that the men harvested did not culture out H. pylori. However, Marshall later discovered that the lab techs were discarding the cultures at the two-day mark, which is customary. H. pylori takes longer than that to grow. Warren and Marshall believed they were on to something.

Put Up or Shut Up…

Marshall tried to replicate his results using piglets, but that didn’t work. In frustration, he had a baseline endoscopy done of himself, wherein a gastroenterologist ran a flexible scope into his stomach to see if anything was amiss. They found Dr. Marshall’s stomach to be as fit and healthy as such organs can be.

Dr. Marshall then cooked up a broth of H. pylori bacteria and drank it himself. He expected it to take about a year to see any discernible effects. Marshall got sick on day 3 after drinking that vile stuff.

His wife first pointed out that her husband had developed some simply ghastly breath. This was due to the H. Pylori bacteria inhibiting stomach acid production, a condition known as achlorhydria. At the end of the first week, he began viciously vomiting.

Now thoroughly sick but intrigued, Dr. Marshall submitted to a second endoscopy that demonstrated massive inflammation and minimal acid production. His H. pylori cultures were positive for the bug. On day 14, he had a third endoscopy and began antibiotics. A short while later, his GI symptoms steadily abated. Repeat endoscopy demonstrated that his stomach was healthy again.

Genius Rewarded

In 2005, Doctors Warren and Marshall traveled to the Karolinska Institute in Stockholm, Sweden, to accept the Nobel Prize in Physiology and Medicine. The official attribution was, “For their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease.” Together, these two guys fundamentally shaped our understanding of stomach ulcers.

The method by which one acquires an H. pylori infection is kind of gross. However, since that time, physicians have begun checking for the presence of H. Pylori bacteria in patients with GI issues. That can involve a biopsy during an endoscopy, a blood test, or something called a Urea breath test.

The typical H. pylori patient has been taking proper stomach medication like omeprazole or pantoprazole for months, yet still has worsening reflux. Sometimes this robs a person of sleep. It reliably takes spicy foods off the menu.

Hope, Inc.

Thanks to Dr. Barry Marshall’s willingness to lay it on the line to chase a hunch, we now have some powerful tools to help get rid of persistent gastric reflux. I diagnose and treat symptomatic H. Pylori infections in my clinic not infrequently.

All that stems back to that day when Dr. Marshall drank that concoction of bacterial sludge just to see if his hunch was correct.

Dr. Marshall’s unconventional approach to his research legitimately changed the world. In doing so, Marshall violated more than a few codified rules of medical research.

It could just as easily have killed him. However, he did end up winning the Nobel Prize, so there’s that. At the end of the day, luck favors the bold, even if that means drinking some vile bacteria cocktail to make your point.