From: gastro@ilhawaii.net (Ed Montell)
Subject: Re: Ulcers and Bacteria
Date: 11 May 1995

In article
<Pine.OSF.3.91j.950510090731.15790B-100000@saul4.u.washington.edu>,
Marilyn Berry <berry@u.washington.edu> wrote:

> I read that the bacteria that cause some ulcers can be passed person to
> person.  But how?

Actually nobody knows for sure how this bug (Helicobacter pylori to the
cogniscenti) is transmitted. However its association with third-world,
poor sanitation and lower socioeconomic groups suggests fecal-oral route
(So remember wash your hands!!!!) like other diseases common to these
situations like Hepatitis A and dysentery.

From: cwerner@dorsai.org (Craig Werner)
Subject: Re: Biaxin/Flagyl combination, bad reaction, I NEED HELP!
Date: 02 Jun 1996
Newsgroups: sci.med,sci.med.pharmacy

Edward J. Mathes, RPA-C (emathes@cyber1.servtech.com) wrote:
: Bob Minton wrote:
: >
: > I was diagnosed May 15 with Helicobacter Pylori for which my gastroenterologist
: > prescribed 500mg Biaxin 2x daily and 500mg Flagyl 3x daily for 7 days along
: > with 20mg Prilosec 2x daily.


: I'm curious, why the addition of flagyl?  Biaxin is very active against H.
: Pylori alone.  I haven't read of this combination yet...
: --


	The original anti-H.pylori therapy was bismuth, tetracyline, and
metronidazole.  Of these, Metronidazole (Flagyl) was thought to have the most
activity, although resistance developed quickly.  When maximal acid suppression
with Prilosec was added people discovered that additional monotherapy with
Amoxicillin or Biaxin could suffice.  The above combo seems to be a hybrid of
the old and new approaches.  Of course both Flagyl and Biaxin have GI side
effects...

From: sbharris@ix.netcom.com (Steven B. Harris)
Subject: Re: Biaxin/Flagyl combination, bad reaction, I NEED HELP!
Date: 09 Jun 1996
Newsgroups: sci.med

In <4pdl00$h8m@usenetz1.news.prodigy.com> RXDX23A@prodigy.com (Karyn
Deyong) writes:

>Help, I was just diagnosed with HP and my doctor prescribed Prilosec,
>Biaxin, and Metronisazole. I'm not one who likes to take any medicine,
>but I guess my level measured in my blood was quite high. Can anybody
>tell me about this infection - what it is, where it comes from, will this
>cure be permanent, etc. I was out of town when my doctor got my results
>and now he is gone. I'm a little nervous.


Nobody knows how Helicobacter pylori is passed, but my guess is that
it's fecal-oral, sort of like polio or cholera or hepatitis A.

Will the cure be permanent?  Maybe.  But you can get reinfected
probably the same way you were infected.  Remember the "fecal veneer"?
Give young kids fluorescent dyes to eat, which come out in feces.  Take
a black light to their houses a week later, and you see fluorescent dye
over every square inch up to the height they can reach.  Adults aren't
much better....

And gay men-- well, we're not even going to talk about gay men....

Take your meds-- they'll kill the bacteria and prevent you from getting
ulcers, maybe even stomach cancer.  The metronidazole may give you a
nasty taste in your mouth, and make you feel a bit woozy.  It will
pass.  Don't drink alcohol and hang in there.


                                           Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Subject: Re: Helicobacter pylorii
Date: 11 Nov 1996
Newsgroups: misc.health.alternative

In <3280648b.0@news.hsonline.net> nataylor@hsonline.net (Noel A.
Taylor) writes:

>In article <3278764d.0@atheria.europa.com>,
>   rsc@europa.com (Roger Cathey) wrote:
>>In article <ray-0310960941420001@ppp046-sf2.sirius.com>, ray@sirius.com, n%
>>says...
>>>
>>>Hi, all--
>>>
>>>Topic for today: Helicobacter pylorii
>>>
>>>1. What are natural treatments for this condition (instead of the
>>>triple treatment of amoxycillin/flagyl/bismuth)?
>>>
>>>2. What is the definitive test for the presence of H. pylorii? If a
>>>body tests positive for the antibodies, does this mean there are H.
>>>pylorii present? Or does it just mean that sometime in the past there
>>>was contact with this bacteria? How long do the antibodies persist?
>>>
>>>Thanks very much.
>>>
>>>Katherine
>>>
>>>"Impossible is a word in the fool's dictionary."
>
>
>The post on the breath test was quite good. One thing left out is that
>helicobacter pylori cannot survive a low pH (highly acidic) environment.
>Use of antacids provides and excellent growth environment for h. pylori;
>use of acid secretion stimulants such as Betaine HCl provides a very poor
>environment for survival of h. pylori. One does not have to utilize
>antibiotic therapy except in very deep-seated h. pylori infections.
>
>						--Noel



   An incredibly dumb post above.  H pylori not only survives high acid
environments very well, but in fact acid environments are the one thing
it thrives in (which is probably why it tries to create acid in
stomachs it infects).  On the contrary, LOW acid or basic environments
are not good for H. pylori, and treatments for lowering acid production
are a part of all successful H. pylori treatments, including those
which use antibiotics.


                                      Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Subject: Re: Quacks and Geniuses in Medicine
Date: 04 Dec 1996
Newsgroups: sci.med.nutrition,sci.med,misc.health.alternative,alt.food

In <32A3B911.63D2@cphl.mindspring.com> Jim Barron
<jdbarron@cphl.mindspring.com> writes:

>There IS a third alternative which you are overlooking:   The
>appropriate evaluation and testing of new ideas (as opposed to
>evaluation based on untested assumptions and unproven conjectures as
>is,more often than not, the case today.)  There IS no excuse for the
>unpardonably long delay in recognizing the validity of the Helicobacter
>pylori connection with ulcers.


   This is an idea put forth about 1980, and by about 1990 Dr.
Marshall, a native Australian, had a nice appointment in the U.S. on
the basis of it, and everybody was starting to treat ulcer patients
with antibiotics.  It took maybe five years to put the funding for the
confirming studies together, run them, and publish.  So the lag time
for the medical community to be converted was what-- five years?
That's not that bad, considering that the average M.D. has to contend
with dozens of new findings a week, just from reading 3 or 4 good
journals.   There is no excuse, you say?  I suppose you were treating
YOUR ulcer patients with antibiotics in 1981?  Advocating it in print,
at least?  References, please?   What I want to know is, where were YOU
when Marshall was in the wilderness, looking for support?  You'd never
heard of him then?  Fancy that.

   It's always easy to say there's no excuse for *other* people not
believing something you think they should have at time X (in
hindsight). It's particularly easy when you yourself don't have to
demonstrate that you did it better, and saw more clearly.

                                     Steve Harris, M.D.

From: sbharris@ix.netcom.com (Steven B. Harris)
Subject: Re: Quacks and Geniuses in Medicine
Date: 06 Dec 1996
Newsgroups: sci.med,misc.health.alternative

In <Pine.BSD.3.90.961205205723.3139B-100000@user1.mnsinc.com> Kavosh
Soltani <kavosh@mnsinc.com> writes:

>Is it true that the doctor had to take the extraordinary
>measure of infecting himself with the bacteria to develop ulcer; and then
>cured himself using antibiotic?  Now, had he a bit of funding, he could
>have had found some volunteers to take a couple of weeks of antibiotics
>and voila!
>
>Oh, well!  We are far from being perfect...




He did infect himself, he didn't develop ulcer.  He got a nasty case of
gastritis and was pretty sick.

Infecting yourself vs infecting volunteers is a big difference in
medicine.  The one is hard to stop.  The other would be practically
impossible with today's human use committees (without the approval of
which you cannot get the experiment published).

                                       Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Subject: Re: HELP WITH HELICOBACTER PYLORI
Date: 24 Dec 1996
Newsgroups: misc.health.alternative

In <59mno5$h66@news-c1.gnn.com> robnbrwn@gnn.com (Robin Brown) writes:

>In article <59hpbv$l28@sjx-ixn4.ix.netcom.com> Steven B. Harris wrote:
>>  She can wait: many people carry the bug for a lifetime.  What she
>>does in the meantime will depend on symptoms.  If she has an ulcer or
>>gastritis, she should suppress it with over the counter H2 blockers
>>like Zantac or Pepsid.  A more effective dose is the prescription dose,
>>which is double what it says on the over-the-counter box.
>>
>>                                       Steve Harris, M.D.
>
>I have never heard of this bacteria before reading this newsgroup. Now it
>seems that everyone knows a lot about it. What is it? What does it do?
>What are the symptoms?
>Robin



   It's a spirochete a little bit like syphilis and Lyme disease.  It
infects the stomach and duodenum.  In most people it's asymptomatic.
In a few it causes inflamation that leads to chronic acid production,
ulcers, and perhaps even stomach cancer.  90% of non-drug induced
ulcers are associated with the bug.

   The bug can live without acid, but prefers acid.  People telling you
that acid will kill the bug or hurt it, are out to lunch.  Infections
in people capable of producing acid, generally have a positive effect
on acid production, if any effect at all.  Afterall, acid is the
stomach's antibacterial.  It stands to reason that the stomach would go
overboard trying to kill a bacterium it didn't like.  Even one that had
evolved so as to be unkillable by this route.

                                            Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative,sci.med,sci.cryonics,sci.life-extension
Subject: Re: Cancer & Nutrition (Linda Eastman McCartney, Vegetarian)
Date: 14 May 1998 08:21:53 GMT

In <6jdf3p$1re$1@uuneo.neosoft.com> ricka@praline.no.neosoft.com (RHA)
writes:

>>   Stomach ulcers are rather like tooth decay.  H. pylori didn't
>>overturn everything we knew about what causes them, or how you treat
>>them.  It just added a bug to the mix.  One people catch again and
>>again.   Do I tell the young male homosexual smoker that his ulcers are
>>caused by H. pylori, and I'll just fix him up righty oh with
>>antibiotics?  No.
>
>
>   Can't resist getting snotty, can you? Your example is, in terms of
>   the original argument, kind of a cheat, isn't it? But, let's go
>   with your modus operandi:
>
>      Illness    Patient                        Treatment
>      -------    -------                        ---------
>      Ulcers     Non-AIDS infected              Antibotic
>                 healthy male
>
>                 AIDS infected male             (Ouch, I'm pulling a
>                                                blank, what's term for
>                                                the drug set: viral
>                                                replication inhibitor?)
>                                                With viral load under
>                                                control--antibotic
>
>



    I wasn't talking about AIDS or HIV.  I'm talking about how quickly
young homosexual males (HIV infected or not) get reinfected with H.
pylori.  Young heterosexual males, too, depending on habits.  It's a
personal contact disease.  And ulcers occur more commonly in young
males, for some reason.

   Smoking greatly exacerbates ulcer formation, as well.  Stopping
smoking is enough to stop ulcers much of the time, and is a lot
healthier than a course of antibiotics.   Antacids also heal ulcers--
that didn't stop being true when H. pylori was identified.

   On the other side of the coin, most people, as you may know, have no
ulcers with H. pylori.  By the time you get to the geriatric popuation,
at least 50% of people have the bug, but no disease.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative,sci.med,sci.cryonics,sci.life-extension
Subject: Re: Cancer & Nutrition (Linda Eastman McCartney, Vegetarian)
Date: 16 May 1998 00:27:21 GMT

In <355B29FE.F39E93C0@dnai.com> Michael Sierchio <kudzu@dnai.com>
writes:

>Steven B. Harris wrote:
>
>>     I wasn't talking about AIDS or HIV.  I'm talking about how quickly
>> young homosexual males (HIV infected or not) get reinfected with H.
>> pylori.  Young heterosexual males, too, depending on habits.  It's a
>> personal contact disease.
>
>Arrghh!  Puhleeze don't call something a "personal contact" disease --
>you'll leave people wondering,  as often was the case in the early
>days of AIDS,  what particular kinds of contact are likely to
>transmit it!
>
>Swapping spit is enough to get a dose of H. pylorii, no?


Possibly.  Fecal-oral transmission, from the epidemiology, seems a much
better way.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.aids,sci.med,sci.med.pharmacy
Subject: H.pylori and Paradigm Shifts (was: HAART ,,, "problems" (shhhhhhh!!!))
Date: 24 Nov 1998 06:15:48 GMT

In <365a1dd3.6362705@news.primenet.com> fredshaw@primenet.com (fred)
writes:

>>>Bennett wrote:
>>>>
>>>>
>>>> It wasn't the pharm companies that resisted: they can make as much
>>>> money from antibiotics as from anything else, and the H2 antagonists
>>>> are still selling by the bucket load.
>>>
>>>Wrong. The entire medical establishment resisted -- the Australian
>>>doctor who revealed his discovery was personally and professionally
>>>maligned and laughed at by the establishment.
>>>
>>
>>Hah, not what I've heard.
>
>Ha! You weren't even born yet, Bennett!



Comment:

    As one who practiced medicine since before anyone had heard of
Camplylobacter pylori (since 1990, Helicobacter pylori), I can tell you
that the establishment did nothing at all to Barry J. Marshall when he
amounced culture of the organism and its relationship to gastritis and
ulcer in a meeting of the Australian College of Physicians in October,
1982.  Rather, the establishment simply went silently out to prove him
wrong.  The trouble was that these studies had proven him right within
5 years (by which time there were a number of randomized controlled
studies to show that antibiotics improved ulcer cure and recurrance
rates).

   Now, given Fred's use of this history in an attempt to make a point
about the blinders that medical progress supposedly wears, it is almost
beyond irony that that FACTS are that the last holdouts AGAINST
Marshall during this time were essentially Duesbergite reactionaries,
who complained that the relationship between H. pylori and gastric
disease hadn't completely fulfilled Koch's postulates (no, I'm not
kidding).  And indeed, H. pylori doens't produce a full human spectrum
of disease in animals, except for previously immunosuppressed ones
(heavy echo of HIV studies).  Moreover, even though a couple of
experimental infections of humans with H. pylori produced impressive
gastritis, the full spectrum of ulcers was not produced there, either.
So the relationship between H. pylori and ulcers remains quite close to
the one between HIV and AIDS.  Of note, the studies in which
antibiotics were shown to decrease ulcer disease were dismissed by
die-hards as being due to some separate effect of antibiotics on
ulcers, which had nothing to do with their effect on H. pylori.  Again,
please note the humor of this affair being used as an argument for the
stupidity and conservatism of the medical establishment, by Fred Shaw,
who is engaged in exactly parallel arguments himself.   Look in the
mirror, Fred: you are what you dispise.

   It is important to remember that this kind of thing is not just a
feature of the debate over H. pylori and HIV-- rather it is feature of
all battles for a shift in point of view in medicine, when a discovery
happens.  For example, those long holdouts who refused to accept the
role of cholesterol in heart disease demanded double blind studies of
lowering cholesterol with mortality as the endpoint, and complained
that until these were done, the association of cholesterol with heart
disease could not be proven causal.  When such studies were at last
done, the last holdouts began arguing that the effect of the
anticholesterol drugs was directly against the atherosclerotic process
by another mechanism not involving cholesterol.  So it goes.  There is
always more than one way to interpret data, and people who don't want
to accept a theory can always find more and more ornate epicycles with
which to interpret what studies have been done.  It is not that further
study ever proves hypotheses.  It is just that, at some point, the
fixes needed in alternative theories to make them agree with data, make
them also too ugly and complicated and cooincidental to be believed.
Unless, of course, you are crazy.

                                           Steve Harris, M.D.


Scand J Gastroenterol Suppl 1989;160:53-8
Campylobacter pylori and ulcer disease--a causal connection?

Wormsley KG

Ninewells Hospital and Medical School, Dundee, Scotland.

A strong positive correlation has been demonstrated between the (antral
mucosal) presence of Campylobacter pylori and active duodenal and
gastric ulceration. Moreover, both duodenal and gastric ulcers heal,
and remain in remission, as a consequence of therapeutic measures which
eradicate C. pylori. However, the Henle-Koch postulates have not been
fulfilled, because C. pylori has not been shown to produce ulcers. As
for the claim that ulcer disease represents an infection with C. pylori
because therapeutic eradication heals ulcers, it has been shown that
antibiotics and metronidazole, as well as bismuth subcitrate, exert
antiulcer actions by mechanisms which do not involve their
antibacterial effects. The association between C. pylori and ulcer
disease, which was noted half a century ago, remains unexplained now as
it did then.

Publication Types:
  Review



PMID: 2683023, UI: 90048903

----------



JAMA 1995 Oct 4;274(13):1064-6

The 1995 Albert Lasker Medical Research Award. Helicobacter pylori. The
etiologic agent for peptic ulcer.

Marshall BJ
Department of Medicine, University of Virginia Health Sciences Center,
Charlottesville, VA, USA.

PMID: 7563460, UI: 96013474

----------



Ann Med 1995 Oct;27(5):565-8

Helicobacter pylori in peptic ulcer: have Koch's postulates been
fulfilled?

Marshall BJ

University of Virginia Health Sciences Center, Charlottesville, USA.

This brief review considers whether or not Koch's postulates have been
fulfilled for Helicobacter pylori and peptic ulceration. The
histological features of peptic ulcer disease in man are active chronic
gastritis with antral predominance, duodenal gastric metaplasia and
active duodenitis. Other features are hyperpepsinogenaemia, relative
postprandial hypergastrinaemia and basal acid hypersecretion. The
macroscopic features are duodenal bulb ulceration or lesser curve and
antral gastric ulceration. At present, gastric colonization with H.
pylori has been produced in small animal species (rats and
mice), but the infection is difficult to establish in immunocompetent
animals, and histological gastritis is unconvincing. In larger animals
the germ-free pig has been the most reliable model but the gastritis
tends to be chronic with little activity. The best examples of acute
infection are in three 'self-administration' experiments in humans. In
these cases acute gastritis with hypochlorhydria developed which, when
it converted to active chronic gastritis, tended to be asymptomatic.
Either the circumstances were incompatible with ulceration, or the
experiments were not continued for the many years necessary to develop
peptic ulceration. It is concluded that only one of the many steps
required for the development of peptic ulceration has so
far been fulfilled, i.e. the ability of H. pylori to produce
histological gastritis in a susceptible host.

Publication Types:
  Review
  Review, academic


PMID: 8541033, UI: 96126378

----------

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative
Subject: Re: Homeopathy could be "bullshit" for all I know!
Date: 17 Feb 1999 03:28:23 GMT

In <7abii4$d15$1@nnrp1.dejanews.com> silverfern@my-dejanews.com writes:

>
>In article <36C8D585.881A4B3D@interlog.com>,
>  happydog@interlog.com wrote:
>> silverfern@my-dejanews.com wrote:
>>
>> >   If they stood a chance, it would be Nobel material on a par with
>> > > Newton or Einstein.
>>
>> A better analogy would be the discovery that h. pylori causes ulcers.
>
>Yes absolutely. That young Australian who did the classic self risking
>thing. He drank some stuff infected with H pylori, gave himself the bug,
>had it confirmed, then treated himself with antibiotics. Real heroic
>stuff. At the same time he made another interesting discovery: people
>with ulcers tend to have low acid stomachs. Received alt med wisdom has
>been that these people should take acids such as apple cider vinegar.
>Fact is, the H pylori just love that acid, and they gobble it up and beg
>for more. Antacids are better for stomach ulcers. Better still, get those
>antibiotics, grit your teeth and get cured. Can't understamd why that
>young man didn't get a Nobel.


    Umm, because it didn't happen the way you say.  The Australian
doctor, Barry Marshall, M.D., did drink a culture of the organism.  But
all he got was gastritis.  No ulcer.  Nor have any animals gotten
ulcers from it.   However, this plus the epidemiology has convinced
most physicians that H. pylori causes most gastritis, and a larger
fraction of duodenal ulcers.  Gastric ulcers, of course, are often
caused by NSAID drugs.

    No, it's not true in the least that Dr. Marshall discovered that
people with "ulcers" have low stomach acids.  It's long been known that
duodenal ulcers are associated with high acid production, and that
hasn't changed.  It's one of the reason this disease is associated with
smoking, and with chronic stress.

  On the other hand, people with gastric ulcers have variable amounts
of acid production, and have long been known to, even in the absense of
NSAID drugs, and that fact convinced many doctors long before H. pylori
that there was some other factor (guessed to be poor mucosal
protection) which caused gastritis independent of acid production.
Marshall simply identified the missing factor.  That's nice, but it's
not Nobel Prize material.  As well give the Nobel to the guy who
discovered that bacteria cause tooth decay.   It's the same sort of
multifactorial process (and incidentally, caused by acid in both
cases).  The fact that blocking acid production helps symptoms, didn't
go away when H. pylori was discovered.  It still does, infection or
not.  In fact, in order to sucessfully treat the infection, the
irritation and wounding caused by the acid must be healed at the same
time the bacterium is killed, which is why acid production blockers are
always given along with the antibiotitics.




>  In the case
>> of Einstein and Newton they both built on previous work.  It was inevitable
>that >> someone would make the same discoveries.


     So with any discovery.  Marshall built on previous work, too.  He
was not by any means the first guy to report the association of
bacteria with GI ulcers.  He was just the latest and last guy to make
the best case that one of them wasn't a secondary epiphenomenon.  Like
those bacteria that would take up residence in a cavity in your tooth,
even if it was caused by the dentist slipping with his drill.

                                   Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative
Subject: Re: Homeopathy could be "bullshit" for all I know!
Date: 18 Feb 1999 00:48:02 GMT

In <36CAC05D.7C70DD1A@interlog.com> Happy Dog <happydog@interlog.com>
writes:

>I had some kind of eye watering stomach pain a few times for about a
>year. Tests, including GI scope, revealed nothing but the doc assumed
>that h. pylori was responsible. I was given ranitidine and never troubled
>again by whatever it was. Painful experience. Only good part was the
>drugs they gave me for the 'scope. They wanted me to rest afterwards but
>I insisted on leaving and walking home right away to enjoy it. No
>antibiotics though.


   Probably because the scope biopsies and or your antibody tests came
back negative.



> Question though.  Three years prior I was given big IV doses of
>antibiotics for a cat bite.  Wouldn't that have killed any h. pylori?


     Maybe, maybe not.  It's tough to kill and it generally takes an
antibiotic of the type you got (undoubtedly Timentin at that time for
that indication), PLUS something else to kill H. pylori.  Bismuth
subsalicylate or metronidazole.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 15 Apr 1999 13:01:30 GMT

In <37158318.6CFF4190@cs.uoregon.edu> Bret Wood
<bretwood@cs.uoregon.edu> writes:

>"Steven B. Harris" wrote:
>>
>>      We'll look when the alternatives are proven as good as the drugs,
>> in head to head double blind tests.
>
>So you're saying, "We'll do the research once someone has done the
>research to prove that our research will be fruitful."  What kind
>of science is that?

    Real science.  It means we won't do the million dollar study until
the pilot $100,000 study is positive.  Which we won't do unless the
$20,000 epidemiologic study indicates there might be something there
(positive epidemiologic correlation is mildly predictive.  Lack of
correlation is strongly predictive).


>That's the same attitude which kept the medical establishment from
>accepting the use of antibiotics to treat gastrointestinal ulcers.


    Yes, gee, it took them a whole 5 years or so to prove this after
the claim was made at the end of 1983, in an obscure meeting in
Australia.   Ironclad evidence was not presented at that time.  Some
guy said he'd cultured bacteria from ulcers-- not the first time this
claim had been made by others (never verified, and not the same
bacteria).  Just a correlation.   There were no prospective studies.
There were no therapeutic studies.  There was no animal model for
bacterial ulcers (and still isn't).   Marshall hadn't yet done his
famous self-inocculation, and even when he did, he didn't get ulcers
(just gastritis).  This was no easy cookie to prove, and it took
awhile.  I think that all in all, medicine did okay on the basis of the
evidence it had.  If you think that massive evidence was ever at any
time presented and univserally ignored, you don't know the history.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.alternative
Subject: Re: *Weird* thing in my stomach??
Date: 3 Jan 2000 10:00:15 GMT

In <84o0lh$2tf$1@bgtnsc02.worldnet.att.net> "Frank"
<babies@worldnet.att.net> writes:

>> Could be an ulcer.  Why don't you get endoscoped and see?
>
>
>An ulcer does not cause a "bulge" in someone's abdomen. There could be ulcer
>structuring at the pylorus causing a gastric outlet obstruction with
>subsequent gastric distension.

   Correct, and that is how you get a bulge with an ulcer.  Such things
(with tenderness) are a lot more common than a ventral hernia which
isn't midline.   In medicine, common things are common.  And generally,
uncommon symptoms from common diseases are more common than uncommon
diseases.

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: alt.health,misc.health.alternative,sci.med.nutrition
Subject: Re: iatrogenic pains
Date: Wed, 15 May 2002 21:04:25 -0600
Message-ID: <abv7s7$llg$1@slb3.atl.mindspring.net>

"Nicolas Martin" <aia@iatrogenic.org> wrote in message
news:aia-077ECC.20013215052002@netnews.attbi.com...
> In article <3ce2ec13$0$232$cc9e4d1f@news.dial.pipex.com>,
>  "mark doran" <doran@dial.pipex.com> wrote:

> >
> > The anti-biotic/H.Pylori case is interesting: I think about 20 years
> > went by before the idea was widely accepted.

Try about 5 years-- 1980 to 1985. I was there. About time enough for word to
get out, the confirming experiments to be done, and word to get around
again. Cut even this period, for the GI-specialty guys.


> > My own shy suggestion is that while
> > this delay was probably partly caused by inertia and stupidity, there's
> > another aspect that people don't want to consider. This is that once a
> > complaint has actually been said to require 'holistic', 'lifestyle'-type
> > therapy - as ulcers were - then it's damned hard to get people to
> > consider a 'pop a pill' solution: a 'lifestyle' issue has a *moral*
> > significance for many people. In fact, all those people I know who
> > want to use the H.Pylori issue as a stick to beat the medical
> > establishment have a bit of a problem coping with the fact that in
> > this case it was the trendy New-Age 'lifestyle' solution that turned
> > out to be a bunch of crap.


Heh.  Remember however that ulcers are not like AIDS or even tooth decay,
where you never see them without the causal organisms. They are a
multifactorial beast like atherosclerosis/heart disease. With ulcers where
bacteria play a primary causal role (sort of like LDL in heart disease), but
by no means the only one. It's very hard for the stomach to ulcerate without
acid, just as advertised, pre-1980.  And lifestyle things like smoking and
stress DO have a role in duodenal ulcers, as does gender and age (young male
smokers are hit hardest, bacteria or no).


> So, doctors are hapless victims of their insistent patients who DEMAND
> antibiotics for illnesses against which they don't work.

Some truth in this.


> Meanwhile the
> undermedication of people with chronic pain continues to be a
> medical-moral scandal. We conclude, then, that docs can be pressured
> into prescribing medications when they are useless, but even pleading
> will not get them to give adequate meds when they are desperately
> needed.

When de-licensure of one sort of another threatens for doctors who don't hew
to the DEA guidelines, yes indeed. Remember the Elizabeth Taylor scandal
where she got "addicted to prescription painkillers" and then blamed her
Hollywood doctors for it? Seems nobody's personally responsible for anything
anymore. Those docs got into a lot of trouble, basically because Ms. Taylor
didn't have a fatal disease. How much pain she was in, only Ms. Taylor
knows. It's irrelevant anyway, you know-- especially when there's that much
publicity and finger-pointing. I can guess she screamed to get the stuff,
then screamed that she'd gotten it. <sigh>. All I know is what I read in the
papers, so can't say for sure. I did, however, once have the same DEA guy
who worked the Taylor case show up in my office in L.A.--- and a gimlet-eyed
mustachioed law-enforcement narc type in a cheap suit he was, too.
Fortunately for me, I had tried hard to avoid prescribing anything C-II in
California, nor did I treat any celebrities. So he went away mighty
disappointed. However, it doesn't take many such experiences to make a
doctor mighty skittish.

> In both cases the results are a disgrace. We end up with
> frightening increases in drug-resistant infections, and people who kill
> themselves because they can't stand the misery.

Yep. Blame the drug laws, which is to say, your neighbors. (And blame Ms.
Elizabeth Taylor if that helps-- she and those of her ilk surely had a hand
in this mess). The only thing people had worse than taking personal
responsibility, is letting their neighbors take personal responsibility. If
it were up to me, you could buy any drug BUT antibiotics, at the local state
liquor store. Without a Rx.  But nobody asked me to be King, so there you
are. I'm a libertarian, so don't blame ME.

> For decades physicians propounded the notion that ulcers were caused by
> an anxiety disorder, the inability to deal with "stress." What was the
> evidence for this diagnosis? Absolutely nothing!

No, that's incorrect. Anxious people do have more acid and more duodenal
ulcers, all other things being equal.


>How do we know there
> was no evidence? Because we now know that peptic ulcers (that aren't
> caused by drugs) are caused by a bacterium, and you can't have evidence
> for something that doesn't exist.

See above. Life's more complicated than this.  Sorry.


> So, for decades millions of people were given a bogus psychiatric
> diagnosis and "treated" with antianxiety medications and psychotherapy,
> wasting billions of dollars to boot.

No, this actually helped. It wasn't as good as antibiotics, but it helped.
If anything, it got them to smoke less <g>.

> You not only ignore this pathetic
> history of misdiagnosis, but you assert that people with ulcers cling to
> the bogus diagnosis foisted on them by docs. The studies on this subject
> do not find that people with ulcers do not want to be properly treated
> with antibiotics, they show that many physicians are not even bothering
> to offer the proper treatment to their clients.

I'd like to see such a study. The GI guys are the ones that definitively
make most of the duodenal ulcer diagnoses, and there's nothing GI guys love
more than acid-suppressors and H. pylori treatment.  Gastric ulcers are a
different matter altogether however, as you may know.

> What have physicians, especially gastroenterologists, learned from the
> ulcer debacle (not yet ended)? After the cure for ulcers was discovered,
> irritable bowel syndrome (IBS) became the leading reason people went to
> gastroenterologists. What is the dominant theory as to what causes IBS?
> Anxiety! Barely skipping a beat, doctors have replaced stress ulcers
> with stress irritable bowel. They have replaced one quack diagnosis with
> another. They have learned nothing.

I'm sympathetic to your argument, except that as a disease without
inflammation, irritable or functional bowel is a really lousy candidate to
be a disease caused by microbe we haven't found yet. However, the same
wasn't (and isn't) true of any ulcerative GI disease, from mouth to anus. If
you had gone on to suggest that perhaps GI docs were then, and now perhaps
still are missing out on a causal organism for (say) Crohn's disease or
ulcerative colitis, you'd have a better case. The problem is that nobody
really thinks these last diseases are caused by nerves. There's something
much more than this wrong-- we just haven't found it.  And everybody knows
it.

> The arrogance, dogma, and ignorance of physcians make them a leading
> cause of death. Adding insult to injury, you suggest that it is the
> victims who are the perpetrators.

When it comes to people suffering needlessly because they can't get
narcotics, that's surely true. The doctors didn't make the laws.

When it comes to people suffering because doctors tell them there's a mental
or anxiety component to their illnesses, we've talked about that before.
This is more a matter of how you sugar coat it.  "All in your head" is
politically incorrect.  "Mind- body holistic therapy" is PC -- as Mark Doran
more or less notes.  But again, conventional doctors should not be your
primary target here, rather alternative medicine.

Finally, if you're angry that there are some diseases for which the true
pathogenic cause hasn't been discovered-- forcing doctors to treat
palliatively and symptomatically--- consider that the NIH puts out about $15
billion in research grants every year. The national medical treatment bill,
however, is well over a trillion.  A 1.5% research budget in any high tech
industry would suck.  If you add all the private biomed research money
(mostly drug development) the total is still only 3%.  Who do you blame for
this?  Why, I'll tell you: your neighbors, again.  Unless acutely ill, they
think they are immortal. They are short-sighted and they'd far rather spend
your tax dollars to make neater military hardware than to find a cure for
what is going to kill them. So they smoke and stand out in the street to
watch the sky for falling airliners <g>.

Do we need all that military hardware-- hundreds of billions of it?
Strictly speaking, no. Half of it would do fine, and increase our medical
research budget by a factor of god-knows what-- 20 times?  Do you know how
long it takes breast cancer and heart disease to kill as many people as
9/11? Answer: about 3, maybe 4 days.  And it happens EVERY 4 days. I'll take
the crazy Saudi fanatic highjackers anytime. At least we know what we can do
about them, the next time. By contrast, when you get that brain tumor or
bone tumor or big stroke, you're probably in just as unfortunate a position
as the people in the top of the WTC North Tower.  Except it will take a
little longer.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition,sci.med
Subject: Re: Nobel Prize for the causes and treatment of stomach ulcers.
Date: 10 Oct 2005 14:34:52 -0700
Message-ID: <1128980092.674840.24010@o13g2000cwo.googlegroups.com>

OmManiPadmeOmelet wrote:
> My question is, how many of the NORMAL population _without_ ulcers is
> also infected with H. pylori? My GI doc indicated that the re-infection
> rate was fairly high post treatment!
>
> So, how come everybody that carries it does not have ulcers?


Resistance varies. How come everybody who gets HIV doesn't get AIDS?
Why don't 5% of people ever get a tooth cavity, no matter what they
eat, and whether they brush or not?


> I still think it's bullS***


You can think whatever you want.


> How do we know that H. pylori is not "normal flora"?


Define "normal."  The important thing is the ulcers go away when you
kill the bug.
Those bacteria that give you tooth decay are normal, inasmuch as more
people have them than not. But if you didn't have them, you'd never get
tooth decay (as we know from animal experiments).  If this is too
complicated for you, that's too bad. It's a complicated world.


> And the reason that ulcer suffers carry it is because nearly EVERYBODY
> does???

No, ulcer suffers have a far higher carriage rate.


> How many "normal" people have been tested for it?

Enough.  Google it.


SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition,sci.med
Subject: Re: Nobel Prize for the causes and treatment of stomach ulcers.
Date: 10 Oct 2005 18:06:31 -0700
Message-ID: <1128992791.850689.13870@g43g2000cwa.googlegroups.com>

Pizza Girl. wrote:
> Ulcers go away when you kill the acid levels too by changing your body pH.


Your body pH doesn't change. But yes, you can change your stomach pH by
taking antacids or blocking acid production. And yes, ulcers go away.
But they come right back when you stop the antacids. If you treat the
bacterium, they don't (until you catch it again).

SBH