Theodore E. Woodward Award: Global warming and the human stomach: microecology follows macroecology.

Just as there have been 20th century changes in our "macroecology," including global warming, there have been alterations in our "microecology," involving the microbial populations that colonize the human body. Helicobacterpylori, an ancient inhabitant of the human stomach, has been disappearing over the course of the 20th century. As such, by comparing H. pylori+ and H. pylori- persons, the consequences of its colonization can be determined. The presence of H. pylori is associated with increased risk for development of gastric cancer and peptic ulceration, and with decreased risk for gastroesophageal reflux disease (GERD) and its sequelae, including esophageal adenocarcinoma. The disappearance of H. pylori (especially cag+ strains), possibly contributing to the risk of these esophageal diseases, may be an indicator for changing human microecology.