We used to think stomach ulcers were caused by emotional problems and aggravation. I still say my kids are giving me ulcers like my parents used to say. But as with most psychological diseases, once we find the real cause they are not psychological anymore. In 1982 it was discovered that ulcers are caused by an infection of the stomach with the bacteria Helicobacter pylori. (H pylori) Doctors Robin Warren and Barry Marshall received the the 2005 Nobel Prize in Physiology and Medicine for this discovery.
H pylori is a very interesting bug. I just found out when this report from 2014 about H pylori and obesity (1) finally came to my attention, that there is a medical journal devoted to H pylori called “Helicobacter.” Before its recent discovery it was thought that bacteria could not live in the hostile acid environment of the stomach. Also H pylori is very hard to grow and detect in the lab. But now we know that H pylori has been a fellow traveler of humans ever since we came out of Africa 60,000 years ago. In the developing world H pylori is in the stomachs of more than 80% of the population. In the US the rate is closer to 50% but decreasing over time and it varies by age and socioeconomic status. The bug is acquired in childhood and the increased rate in older people reflects the acquisition in childhood of each generation. The vast majority of people infected with H pylori never have a problem. But it can cause ulcers and gastritis and stomach cancer. Why that happens in only a few people with H pylori infection is unknown. If you take the prescribed cocktail of clarithromycin, amoxicillin and a PPI (proton pump inhibitor) antacid for 14 days the infection and the ulcer goes away.
More recently it has been found that H pylori infection decreases the prevalence of obesity. In this report 10% of obese children undergoing scoping study of their stomachs for various complaints had H pylori while 21% of normal weight children did. The other way around, 39% of children without H pylori were obese but only 21% of children with it were obese. So having this germ in your stomach is associated with a 50% reduction in the odds of being obese. Why this might be is unknown but treatment and cure of H pylori infection has been found to increase subsequent weight gain in other studies.
Maybe some day this amazing newly discovered germ will help us realize that obesity is also not a psychological disorder of bad behavior.
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- firstname.lastname@example.org or phone-354-6605.