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Barry J. Marshall of Australia received the joint Nobel Prize for Medicine on Dec. 10, 2005, in Stockholm, Sweden. He proved that bacterial infection was the cause of peptic ulcers. (Pascal Le Segretain/Getty Images)
For centuries, infection has been a major killer. Then several years ago, it appeared that antibiotics had largely eradicated this menace.
But unexpectedly the AIDS virus struck with a vengeance. Now scientists are linking infection to peptic ulcers, heart attack, and cancer. So how can you protect yourself and your family from these serious illnesses?
In 1984, an Australian physician, Barry Marshall, decided to prove that his theory of infection was right. He drank a bacteria-laced concoction to show that it was bacteria, not stress, that caused peptic ulcers. Subsequent studies confirmed that most ulcers are infected with a bacterium called H. pylori.
But here’s a problem. About half the people over 60 years of age have H. pylori in their stomachs. But only about 5 to 20 percent suffer from ulcers. In fact, it’s believed that H. pylori may even decrease stomach acid and help to ease heartburn in some cases. It’s obvious that treating everyone who has H. pylori is not a prudent move.
We also know that there are other causes of ulcers. Patients taking non-steroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin cause about 25 percent of ulcer cases.
So what do doctors do? Patients with ulcer symptoms such as pain that is eased by eating and recurs several hours later or during the night should be tested for H. pylori.
Some doctors routinely use endoscopy, in which a lighted instrument is inserted down the throat to examine the stomach and upper part of the small bowel. If an ulcer is present, a combination of antibiotics is prescribed to eliminate H. pylori.
Can H. pylori trigger cancer? Since H. pylori is so common, and stomach cancer rare, it’s not a major cause. But researchers believe that by causing chronic irritation to the stomach’s lining, it may on occasion trigger malignancy. It therefore makes sense that patients with a family history of stomach cancer should be tested for H. pylori.
Other cancers are linked to infection. For instance, cancer of the liver has increased in recent years due to infection with the hepatitis B virus. It occurs in people who have multiple sexual partners or who inject illegal drugs.
Today it’s believed that cervical cancer is due to the human papilloma virus. It’s an extremely common infection, but only a tiny fraction of women who carry the virus develop cancer.
The best protection is the annual Pap smear. If the smear shows abnormal changes, a microscopic examination and biopsy of the cervix can be done to rule out precancerous disease.
For years, it’s been believed that heart attack results from clogged arteries due to atherosclerosis. Now cardiologists have found that narrowed, clogged vessels are often inflamed, which contributes to coronary attack and strokes.
Doctors are uncertain whether infection causes the inflammation. But they can monitor the degree of infection by a test called C-reactive protein (CRP). If you have a family history of early heart disease, increased cholesterol, diabetes, or hypertension, it makes sense to have this test done.
Will we ever be able to wipe out infection? I doubt it. Germs will be here long after humans have destroyed our planet one way or another.Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com.
