Surprising mechanism of acid reflux damage

Surprising mechanism of acid reflux damage
 

Gastroesophageal reflux disease (GERD) is an extremely common disorder of the esophagus that affects 20 percent of adult Americans. In severe cases, it can lead to bleeding ulcers in the esophagus and it can be associated with a dangerous condition called Barrett's esophagus, which can lead to esophageal cancer.

For more than 80 years, it has been assumed that stomach acid backing up through the esophagus damaged the lining of the esophagus by causing chemical burns, but their research suggests that the damage in patients with GERD actually occurs through an inflammatory response prompted by the secretion of proteins called cytokines.

The research builds on previous work in mice demonstrating that it takes several weeks from the time stomach acid is introduced into the esophagus before damage occurs.

"A chemical burn should develop immediately, as it does if you spill battery acid on your hand," said co-senior author.

In the current study, the researchers looked at patients at the VA North Texas Health Care System's Dallas VA Medical Center who had reflux esophagitis that had been successfully treated by medicines called proton pump inhibitors (PPIs). The researchers thought that GERD might redevelop if PPIs were stopped, providing an opportunity to observe the early changes of GERD.

In 11 of 12 patients with reflux esophagitis, an injury to the lining of the esophagus, changes to the esophagus reoccurred after the PPIs were stopped. Importantly, the changes that re-occurred were not consistent with chemical burns. Rather, the findings supported the new idea that refluxed stomach acid stimulates the esophagus to make small proteins called cytokines, which then sets up the process of inflammation.

"This study challenges some of the long-held beliefs about how gastroesophageal reflux damages the esophageal mucosa in patients with gastroesophageal reflux disease," said first author.

"We think that it is important for physicians to have an accurate understanding of the mechanisms underlying the diseases that we treat, especially one as common as GERD," co-senior author said. "Furthermore, our study should open up new avenues for novel GERD treatments."


http://www.utsouthwestern.edu/newsroom/news-releases/year-2016/may/acid-reflux-damage.html

Edited

Rating

Item has a rating of 5 1 vote
Rating: