History of Helicobacter pylori , duodenal ulcer, gastric ulcer and gastric cancer
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Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician's believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for "surgical disease" or for "Sippy" diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori-related diseases.
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H. pylori infection can lead to antrum-predominant gastritis, in which the oxyntic mucosa is not inflamed but a gastrin-driven increase in acid output occurs, along with the possible development of duodenal ulcer.
“H. pylori infection can lead to antrum-predominant gastritis, in which the oxyntic mucosa is not inflamed but a gastrin-driven increase in acid output occurs, along with the possible development of duodenal ulcer[67,68].”
From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [68]
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Self-citation
- Authors
- Graham, D. Y.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- Corresponding author
- Graham, David Y
- ORCID
- Graham, David Y
- Venue
- World Journal of Gastroenterology
- Publisher
- Baishideng Publishing Group Inc.
- Published
- 2014
- Volume
- 20
- Issue
- 18
- Pages
- 5191
- ISSN
- 1007-9327 (ISSN-L)
- PMC
- PMC4017034
- OpenAlex
- W2058759666
- Cited by
- 357
- References
- 66
- Citations by year
- 2026: 14 · 2025: 40 · 2024: 34 · 2023: 38 · 2022: 37 · 2021: 41 · 2020: 34 · 2019: 36 · 2018: 36 · 2017: 18 · 2016: 14 · 2015: 13 · 2014: 2
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- World Journal of Gastroenterology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs (DK56338)
- Office of Research and Development
- National Institute of Diabetes and Digestive and Kidney Diseases (DK56338, DK062813, R01DK062813, P30DK056338)
- Topics
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Social Sciences › Arts and Humanities › History and Philosophy of Science › History of Science and Medicine
- Social Sciences › Arts and Humanities › Archeology › Paleopathology and ancient diseases
- Keywords
- Helicobacter pylori, history of medicine, duodenal ulcer, gastric ulcer, gastric cancer, atrophic gastritis, environmental factors, sanitation, diet, vitamin deficiency, pediatric infection, ulcer diagnosis
- MeSH terms
- Animals, Duodenal Ulcer, Humans, Risk Factors, Stomach, Stomach Neoplasms, Stomach Ulcer, Time Factors, Prevalence, Helicobacter pylori, Helicobacter Infections, History, 17th Century, History, 18th Century, History, 19th Century, History, 20th Century, History, 21st Century, History, Ancient
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