The surprising cause of stomach ulcers - Rusha Modi

翻译人员: Liyu Liu 校对人员: Qinyang Zeng

In 1984, an enterprising Australian doctor named Barry Marshall

在1984年，一位雄心勃勃的 澳大利亚医生巴里·马歇尔

决定冒个险。

decided to take a risk.

Too many of his patients were complaining of severe abdominal pain

他有许多病人抱怨因胃溃疡

而产生的腹痛，

due to stomach ulcers,

which are sores in the lining of the upper intestinal tract.

胃溃疡就是上消化道黏膜的疮口。

At the time, few effective treatments for ulcers existed,

在当时，有效治疗 溃疡的方法十分有限，

and many sufferers required hospitalization or even surgery.

许多溃疡患者需要 住院甚至接受手术。

Desperate for answers,

因为渴望得到答案，

Dr. Marshall swallowed a cloudy broth of bacteria

马歇尔医生吞下了 从他的一位病人的胃里

collected from the stomach of one of his patients.

收集来的浑浊的细菌液体。

Soon, Dr. Marshall was experiencing the same abdominal pain,

很快，马歇尔医生 也经历了同样的腹痛、

bloating,

腹胀

and vomiting.

和呕吐。

Ten days later, a camera called an endoscope

十天后，一种叫内窥镜的相机

peered inside his insides.

被插入了他的食道。

Marshall's stomach was teeming with the same bacteria as his patient.

结果发现马歇尔的胃里充满着 和他的病人体内相同的细菌。

He'd also developed gastritis, or severe inflammation of the stomach,

同时，他也并发了胃炎， 即胃部的严重发炎，

the hallmark precursor of ulcers.

这是溃疡的典型前兆。

Dr. Marshall's idea challenged

马歇尔医生的想法

挑战了一个至今仍然存在的误解：

a misconception that still persists to this day:

that ulcers are caused by stress,

那就是溃疡是由压力、

food,

食物

or too much stomach acid.

或者胃酸过多引起的。

Marshall thought the culprit was bacterial infections.

马歇尔认为病因是细菌感染。

起初，全球最聪明的医疗学者们

Initially, his idea was considered crazy

by the brightest medical minds on the planet.

都认为他的这个想法十分疯狂。

But in 2005, he and Dr. Robin Warren received the ultimate validation

但在2005年，他和罗宾·沃伦博士 获诺贝尔医学奖的时候，

when they were awarded the Nobel Prize for medicine.

这一想法最终得到了证实。

Our stomachs are J-shaped organs with surprisingly intricate ecosystems

我们的胃是个J字形的器官， 有着十分复杂生态系统，

awash in hormones and chemicals.

充满了激素和化学物质。

The stomach is under constant attack by digestive enzymes,

胃一直处在消化酶、

bile,

胆汁、

proteins,

蛋白质、

microbes,

微生物

and the stomach's own acid.

和胃酸的攻击之下。

In response, it produces bicarbonate,

反过来，胃会产生碳酸氢盐、

mucus,

粘液

and phospholipids called prostaglandins

和被称为前列腺素的磷脂

to maintain the integrity of its own lining.

来维持黏膜自身的完整。

This delicate balance is constantly regulated

这一持续性的巧妙平衡

and referred to as mucosal defense.

被称作黏膜防御。

Since the mid-1800s, doctors thought stress alone caused most stomach ulcers.

自 19 世纪中叶，医生一直认为 压力是导致大多数胃溃疡的病因。

Patients were given antidepressants or tranquilizers

他们会给病人服用 抗抑郁症药或注射镇定剂，

and told to visit health spas.

让病人去温泉疗养。

This belief eventually shifted to the related notion of spicy foods

这一信念最终转变为 将食用辛辣食物和压力

and stress as culprits.

作为病因的相关概念。

Yet no convincing study has ever demonstrated that emotional upset,

然而没有任何令人信服的 研究证明情绪不安，

psychological distress,

心理困扰

or spicy food

和食用辛辣食物

directly causes ulcer disease.

会直接导致溃疡的产生。

By the mid-20th century, it was widely accepted that excess hydrochloric acid

到20世纪中叶， 人们普遍相信过量的盐酸

prompted the stomach to eat itself.

会刺激胃侵蚀自身。

Fervent proponents of this idea were referred to as the acid mafia.

这一观念的热情支持者 被称作“胃酸黑手党”。

The biggest hole in this theory was that antiacids only provide

这一理论的最大破绽是抗酸剂只能

temporary relief.

暂时缓解症状。

We now know that some rare ulcers

我们现在知道一些罕见的溃疡

are indeed caused by too much hydrochloric acid.

确实是由过多的盐酸导致的。

But they make up less than 1% of all cases.

但这在所有病因中只占不到1%。

Dr. Marshall and Dr. Warren pinpointed a spiral-shaped bacteria

马歇尔医生和沃伦博士准确指出了 一种叫做幽门螺旋杆菌的

called Helicobacter pylori, or H. pylori, as the real offender.

螺旋形的细菌，或简称H. Pylori， 才是真正的罪魁祸首。

H. pylori is one of humanity's oldest and most frequent companions,

幽门螺旋杆菌是人类 最古老、最常见的伙伴之一，

having joined us at least 50,000 years ago,

至少在五万年前 就已经在我们身边存在了，

and now found in 50% of people.

现在，在一半的人体内 仍然能发现这种细菌。

Previously, we thought the stomach was sterile

从前，我们认为胃里面是无菌的，

on account of it being such an acidic, hostile environment.

因为胃的内部是一个 如此高酸度的恶劣环境。

Yet H. pylori survives the acidic turmoil of the stomach

然而，幽门螺旋杆菌能 在胃部的酸性涤荡中存活，

with a variety of features that disrupt mucosal defense in its favor.

具备各种对其自身有利的 黏膜防御破坏性特征。

For example, it produces an enzyme called urease

比方说，它会产生一种叫脲酶的酶，

that helps protect it from the surrounding gastric acid.

来保护其免受周围胃酸的侵袭。

H. pylori can make over 1,500 proteins,

幽门螺旋杆菌会制造 超过1500种蛋白质，

many of which are dedicated to maximizing its virulence.

大多数都致力于将毒力最大化。

We still have unanswered questions,

我们仍有未解答的疑问，

like why specific people develop ulcers at particular times.

比方说为什么特殊的人会 在特定的时间患有溃疡。

However, we do know individual genetics,

然而，我们也知道个人遗传学、

other medical problems,

其他医学问题、

use of certain medications,

使用特定的药物、

smoking,

吸烟

and the genetic diversity of Helicobacter strains all play a role.

以及幽门螺杆菌菌株的遗传多样性 都在其中发挥了作用。

特别是一些用来缓解 关节炎症的特定止痛药

In particular, certain pain medications used to reduce inflammation in joints

have been discovered to work with H. pylori

被发现能协同幽门螺旋杆菌

to create more severe stomach ulcers.

激发更加严重的胃溃疡。

Dr. Marshall ended up being fine after his famous, albeit dangerous, experiment.

这个著名的实验虽然十分危险， 马歇尔医生最终却平安无事。

He ingested a course of antibiotics similar to the ones taken now for ulcers.

他摄入了一种抗生素， 类似于现在用以治疗溃疡的药物。

To be treated by simple antibiotics is a modern triumph

用简单的抗生素来治疗 过去需要做手术才能治愈的疾病

for a disease that previously needed surgery.

是现代的胜利。

Marshall's work also reminded us that scientific progress is not always smooth.

马歇尔的工作也提醒我们 科学进步并不总是一帆风顺的。

But there's value in trusting your proverbial,

但是，相信你自己的格言是有价值的，

and sometimes literal, gut.

或者直白点，相信你自己的肠道 （译注：gut也有勇气的意思）。