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Australians Win Nobel in Medicine For Study of Bacteria in Stomach

By Lawrence K. Altman

Two Australian scientists who upset medical dogma by discovering a bacterium that causes stomach inflammation, ulcers and cancer won the 2005 Nobel Prize for Physiology or Medicine on Monday.

The winners were Dr. Barry J. Marshall, 54, a gastroenterologist from the University of Western Australia in Nedlands, and Dr. J. Robin Warren, 68, a retired pathologist from the Royal Perth Hospital.

The findings by the Australians in the early 1980s went so against medical thinking, which held that psychological stress caused stomach and duodenal ulcers, that it took many more years for an entrenched medical profession to accept it.

In its citation, the Nobel committee from the Karolinska Institute in Stockholm said that Marshall and Warren “made an irrefutable case that the bacterium Helicobacter pylori” causes ulcers and other diseases.

“It is now firmly established that H. pylori causes more than 90 percent of duodenal ulcers and up to 80 percent of gastric ulcers,” the Nobel committee said.

In the wake of the ulcer discovery, many scientists have been seeking unknown infectious agents as the cause of many chronic diseases. Examples include microbes that might produce atherosclerosis, the underlying basis of coronary artery disease; ulcerative colitis; regional enteritis (Crohn’s disease); and rheumatoid arthritis.

When the two began their research, doctors could heal ulcers with drugs that blocked the production of gastric acid, believing stomach acid caused ulcers. But the ulcers often relapsed because the bacteria remained to perpetuate the inflammation that leads to ulcers and to certain cancers.

Ulcers at that time were often a chronic, debilitating disease that required major surgery and that could cause life-threatening complications from bleeding. Also, they would often erode through the stomach and lead to peritonitis.