Chapter 3 : One Hundred Years of Discovery and Rediscovery of and Its Association with Peptic Ulcer Disease

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This chapter provides an overview of four storylines of spiral bacteria, epidemic gastritis with hypochlorhydria, urease, and bismuth therapy. The interest of pathologists and anatomists in the spiral bacterium remained rather focused, however, and divorced from clinical observations on gastric diseases. For this reason, persons studying gastritis and clinicians studying peptic ulcer disease were generally unaware of the spirochete literature, and never considered bacterial causes of gastric diseases. The epidemic-gastritis-with-hypochlorhydria syndrome remained in the medical textbooks until about the mid-1960s, when its rarity led to its deletion from most chapters on gastritis or gastroenterology. It was, therefore, a surprise when investigators began encountering epidemics of hypochlorhydria in the 1970s when it again became popular to study gastric acid secretion by passing nasogastric tubes in volunteers. The hypochlorhydria lasted several months and was associated initially with a vomiting illness and even abnormal liver function tests in a few individuals. Gastric urease remained a little-studied phenomenon until the high urease production of and other helicobacters was observed first by Langenberg. Knowledge of gastric urease and observations on the urea concentration in gastric juice by Marshall and Langton in 1984 led to the development of the urea breath test, a noninvasive form of detecting gastric urease. Bismosal was a suspension of bismuth subsalicylate, which, unlike some other salts of bismuth, for example, the subnitrate, was relatively insoluble and had low toxicity.

Citation: Marshall B. 2001. One Hundred Years of Discovery and Rediscovery of and Its Association with Peptic Ulcer Disease, p 19-24. In Mobley H, Mendz G, Hazell S (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555818005.ch3
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