Treatment of duodenal ulceration with Furazolidone in China preceded the discovery of its association with H pylori

Abstract

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TO THE EDITOR

It is not generally known that patients with duodenal ulceration were being treated with an antibiotic, Furazolidone, in China five or more years before Marshall and Warren[1] published their seminal paper in 1984 about the association between duodenal ulceration and Campylobacter like organisms in the stomach, later named H pylori. Marshall and Warren won the 2005 Nobel Prize in physiology or medicine for their work on how a bacterium can relate to gastric inflammation or peptic ulceration.

In 1981 I was invited by the Bureau of Health to a lecture/research tour of rice-growing areas of China in connection with research into the geographical prevalence of duodenal ulceration in relationship to staple diets. During that visit I met Professor Zhi-Tian Zheng at the Third Teaching Hospital in Beijing, and he told me about a series of duodenal ulcer patients, 80% of whose ulcers had healed, and had remained healed for 3 years, following a 2 wk course of treatment with Furazolidone. At the time I was very sceptical about this.

I was invited back to China in 1984, this time to make a tour of the wheat and millet-growing areas, and once again I visited Professor Zhi-Tian Zheng in Beijing. By then he had gathered a much larger number of patients whose duodenal ulcers had healed following treatment with Furazolidone, and who were remaining in remission. I persuaded him to publish this, and a letter from him and his colleagues appeared in The Lancet in 1985[2].

Later in this tour I found that Professor Huai-Yu Zhao in Lanzhou had similar findings which he and his colleagues also reported later in the same year in a letter to The Lancet[3].

It seems only right that Professors Zhi-Tian Zheng and Huai-Yu Zhao and their colleagues in China should have some of the credit for having linked persistence and recurrence of duodenal ulceration with a bacterial infection.