Academic Reading — Test 35

Reading passage

For much of the twentieth century, the medical profession held a firm and widely shared belief about the origins of peptic ulcers, the painful sores that form in the lining of the stomach and the upper part of the small intestine. These ulcers were thought to be the product of an essentially modern way of life. Stress, spicy food, smoking and an excess of stomach acid were blamed, and the prevailing wisdom held that the human stomach was far too acidic an environment for any bacterium to survive within it. Treatment, accordingly, focused on neutralising or suppressing acid and on advising patients to calm their nerves. Such measures often eased the symptoms for a time, yet the ulcers frequently returned, leaving sufferers trapped in a cycle of relapse that could last for years. This settled picture began to unravel in the early 1980s in the Australian city of Perth. Robin Warren, a pathologist, had noticed curious spiral-shaped bacteria clinging to tissue samples taken from the stomachs of patients with inflammation. The organisms appeared again and again, always in the company of damaged or irritated tissue, yet his colleagues paid them little attention, assuming they were harmless contaminants or simply an oddity of no real importance. Warren, however, suspected that the relationship was not coincidental. He was joined by Barry Marshall, a young physician in training, who shared his curiosity and was willing to pursue the question with the persistence it demanded. Together the two men set about cultivating the bacterium in the laboratory, a task that proved far more difficult than expected. Their early attempts to grow the organism on culture plates failed repeatedly, and they began to doubt whether it could be cultured at all. Success came almost by accident over the Easter holiday of 1982, when a batch of plates was left undisturbed for several days longer than the usual two-day routine. The extended incubation gave the slow-growing bacterium the time it needed to form visible colonies. The organism was eventually named Helicobacter pylori, a reference to its helical shape and to the pylorus, the region of the stomach where it tends to congregate. Identifying the bacterium was one matter; persuading the wider scientific community that it actually caused disease was quite another. The idea ran directly against decades of orthodoxy, and many researchers remained sceptical, pointing out that the presence of an organism does not by itself prove that it is responsible for illness. Frustrated by the slow pace of acceptance and lacking a suitable animal in which to reproduce the condition, Marshall took an extraordinary step in 1984. He deliberately drank a solution containing a culture of the bacteria. Within days he developed gastritis, an inflammation of the stomach lining, complete with nausea and discomfort, and biopsies confirmed that the bacterium had colonised his stomach. He then treated himself with antibiotics and recovered. This dramatic act of self-experimentation, though hardly a controlled trial, supplied compelling evidence that the organism could indeed provoke disease in a healthy person. The implications of the discovery were considerable, for it meant that many ulcers were not a chronic lifestyle condition to be managed indefinitely but rather an infection that could be cured. A short course of antibiotics, combined with drugs that reduce acid, could eliminate the bacterium and allow the ulcer to heal permanently, sparing patients the endless relapses of the past and, in some cases, the need for surgery. Acceptance nonetheless came gradually, and it was not until the 1990s that the medical establishment broadly endorsed the bacterial explanation and revised its treatment guidelines accordingly. The transformation in patient care was substantial, and the financial savings to health systems around the world proved enormous. The significance of the work extended beyond the treatment of ulcers alone. Persistent infection with Helicobacter pylori was later linked to certain cancers of the stomach, lending the discovery an added weight in the field of cancer prevention. In 2005 Marshall and Warren were awarded the Nobel Prize in Physiology or Medicine, a recognition that came more than two decades after their first observations. Their story is often cited as a reminder that established belief, however confidently held, may still be overturned by careful observation and the willingness to question what everyone assumes to be true. It also illustrates how a finding that is initially dismissed can, with patience and evidence, come to reshape an entire branch of medicine.