Variation of the Intercellular Space in the Esophageal Epithelium in Response to Hydrochloridric Acid Infusion in Patients with Erosive Esophagitis

Abstract

ABSTRACT:The purpose of this study was to compare esophageal infusion with 0.1 N hydrochloridric acid (HCl) to esophageal infusion with saline in patients presenting with typical gastroesophageal reflux symptoms and erosive esophagitis.METHODS:Upper gastrointestinal endoscopy was performed on 44 prospective subjects, 29 of whom were included in the study. Eighteen patients presented with normal esophagi (Control Group “C”), nine of whom were infused with HCl and nine with saline. Eleven patients presented with erosive esophagitis (Lesion Group “L”), five of whom were infused with HCl and six with saline. Biopsies of the esophageal mucosa were collected before and after infusions.RESULTS:No statistically significant difference was found between the two types of infusions in terms of the dilation of the intercellular space of the esophageal epithelium, regardless of the status of the patient.CONCLUSIONS:Response to HCl infusion cannot be used as a marker for gastroesophageal reflux disease.

Gastro‐oesophageal reflux disease is associated with up‐regulation of desmosomal components in oesophageal mucosa

“…In animal models, exposure to acid, pepsin, bile acids and physical stress provokes DIS, 45,46 which can lead to reduced transepithelial electrical resistance and increased transepithelial permeability in rabbit and mouse models 45,46 . Although there is one study in humans that did not find impaired epithelial resistance/increased permeability after the infusion of hydrochloric acid, 47 overall there are reliable data showing that luminal exposure to mixed gastric or gastroduodenal refluxate can lead to cellular damage and oesophagitis 6,48 . Recently, on the basis of work with a rat model, Souza et al.…”