Rapid progress in gastroenterological research, during past century, was initiated by the discovery by W. Prout in early 18th century of the presence of inorganic,
hydrochloric acid in the stomach and by I.P. Pavlov at the end of 19th century of neuro-reflex stimulation of secretion of this
acid that was awarded by Nobel prize in 1904. Then, J. W. Black, who followed L. Popielski's concept of
histamine involvement in the stimulation of this secretion, was awarded second Nobel prize in gastrology within the same century for the identification of
histamine H2-receptor (H2-R) antagonists, potent gastric acid inhibitors, accelerating
ulcer healing. The concept of H2-R interaction with other receptors such as
muscarinic receptors (M3-R), mediating the action of acetylocholine released from local
cholinergic nerves, and those mediating the action of
gastrin (CCK2-R) on parietal cells, has been confirmed both in vivo studies and in vitro isolated parietal cells. The discovery of H2-R antagonists by Black and their usefulness in control of gastric secretion and
ulcer healing, were considered as real breakthrough both in elucidation of gastric secretory mechanisms and in
ulcer therapy. Discovery of even more powerful gastric acid
inhibitors, proton pump inhibitors (PPI), also highly effective in acceleration of
ulcer healing was, however, not awarded Nobel prize. Unexpectedly, two Australian clinical researchers, R.J. Warren and B.J. Marshall, who discovered in the stomach spiral bacteria, named Helicobacter pylori, received the third in past century Nobel prize in gastrology for the finding that this bacterium, is related to the pathogenesis of
gastritis and
peptic ulcer. They documented that eradication of H. pylori from the stomach, using
antibiotics and potent gastric inhibitors, not only accelerates healing of
ulcer but also prevents its recurrence, the finding considered as greatest discovery in practical gastrology during last century. Thus, the outstanding achievements in gastroenterology during last century have been awarded by three Nobel prizes and appreciated by millions of
ulcer patients all over the world.