Has the human stomach passed its sell by date?

The discovery of Helicobacter pylori and the recognition that it caused gastritis, duodenitis, peptic ulceration and gastric cancer held the promise that its eradication would prevent these diseases. However, the decline in peptic ulcer disease has been accompanied by a rapid and inexorable rise of gastro-oesophageal reflux disease (GORD) together with an increased incidence of Barrett’s oesophagus and oesophageal adenocarcinoma. Complications arising from peptic ulcer in the elderly have shown no diminution and they continue to cause morbidity and mortality.An epidemic of obesity has overtaken the world population causing a fall in the quality of life and an increase in obesity related diseases such as diabetes, hypertension and osteoarthritis. The most effective treatment for the majority of patients with morbid obesity is bariatric surgery that often involves a mutilating operation designed to exclude or by-pass most of the stomach.Having solved a major cause of stomach related illness, nature has responded with new diseases unassociated with H. pylori but nevertheless generated by the stomach. In today’s environment this organ has become a liability to health and has passed its evolutionary “sell by date”.