Jul. 15--Winning a Nobel Prize requires a number of variables. Hard work. Intelligence. Luck. Guts.

In Dr. Barry Marshall's case, his win involved guts, all right. His own.

Marshall, a clinical professor of microbiology and medicine at the University of Western Australia, and Robin Warren, a clinical pathologist who has worked most of his career at Royal Perth Hospital, won the Nobel Prize for physiology or medicine in 2005. They proved that the bacteria Helicobacter pylori causes peptic ulcers and gastric cancer. As part of the experimental process, Marshall drank a culture of the bacteria and developed severe stomach inflammation. He then cured himself, proving that he had come up with the right combination of drugs to kill the bacteria and to eliminate ulcers.

Marshall recently visited Wake Forest University Baptist Medical Center, where he went on grand rounds and made a presentation. He talked about how people are usually infected with the bacteria in childhood and carry the infection throughout their lives. About half of the world's population harbors the bacteria, but most people show no symptoms from the infection. Those who do are at risk for ulcers and cancer.

Marshall showed a short film, produced by www.nobelprize.org, in which his discovery was said to have turned established medical theory on its head.

"We were looked on as being a bit crazy," said Warren in the film. Doctors had long believed that peptic ulcers were caused by stress, spicy food and alcohol. They thought that bacteria couldn't grow in the stomach.

"As a rule, they don't," Warren said. "But these do."

Warren had found spiral-shaped bacteria in tissue taken from the stomachs of many patients who had gone through gastroscopies, examinations of the stomach to look for abnormalities. He noticed that the samples showed signs of inflammation, and he thought that perhaps the bacteria caused gastritis. Marshall, who was looking for a research project, met Warren during his internal-medicine training at Royal Perth Hospital in 1981. They joined forces. In 1984, Marshall drank the bacteria.

At the medical center, Marshall said that his decision to experiment on himself is not unusual in medical circles. Dr. Werner Forssmann performed the first angioplasty on himself in 1929 when he anesthetized his arm, then maneuvered a catheter through a vein and into his heart. In the 1970s, Dr. David Clyde, who was trying to develop a vaccine for malaria, allowed infected mosquitoes to bite him and give him the disease.

Marshall had kept his self-experimentation to himself. When he finally talked about it, he said, "Everyone in my family got paranoid that they caught it." They didn't.

Marshall's and Warren's work has been called the most significant discovery in the history of gastroenterology, similar to such finds as vaccines for polio and smallpox.

In 1926, a Danish scientist won a Nobel Prize with his claims that a parasitic worm caused stomach cancer in mice and rats.

"We discovered the cause for stomach cancer, not him," Marshall said. "The great thing about the Nobel Prize (as far as the Danish scientist is concerned) is they can never take it back."

Janice Gaston can be reached at 727-7364 or at jgaston@wsjournal.com.

-----

To see more of the Winston-Salem Journal, or to subscribe to the newspaper, go to http://www.journalnow.com/.

Copyright (c) 2009, Winston-Salem Journal, N.C.

Distributed by McClatchy-Tribune Information Services.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.