Acid hypersensitivity in patients with eosinophilic oesophagitis

Abstract

Patients with eosinophilic oesophagitis are hypersensitive to acid perfused in the oesophagus, and pathophysiologic findings are likely confined to the peripheral tissue. Reflux from physiological acid may play a role in the symptoms of eosinophilic oesophagitis.

Clinical Case Report of PPI-refractory Gastro-Esophageal Reflux Disease (GERD) with Korean Medicine Treatment - A Focus on Evaluation of the Abdominal Examination

“…Studying esophageal hypersensitivity in patients with GERD-indicating symptoms may change our understanding of GERD and other functional esophageal diseases. Therefore, one potential future direction in the diagnosis of patients with refractory heartburn or NCCP may be sensory assessment with multimodal probes integrating electrical, mechanical, thermal and chemical stimuli (84) in addition to esophageal impedance, pH and motility testing. Additionally, pharmacogenomics may help us in selecting sufficient doses of PPIs and predicting response to therapy.…”

Eosinophilic Esophagitis–More than Two Decades of Progress

“…Patients with EoE were shown to be hypersensitive to acid, and therefore reflux likely plays a role in causation of symptoms [47]. In a study comparing PPI therapy to topical steroids in EoE adults with dysphagia, both groups had similar improvement in symptoms and eosinophilic infiltration regardless of underlying concomitant GERD, however this study was limited by a small cohort [48].…”

Proton Pump Inhibitor Therapy in Eosinophilic Esophagitis: Current Role and Future Perspectives

“…EoE patients have been recently shown to have lower thresholds for onset of symptoms and pain after esophageal acid infusion when compared to healthy volunteers [27]. As a matter of fact, EoE patients without GERD showed an earlier burning sensation than EoE patients with concomitant GERD or healthy volunteers after esophageal acid infusion [27].…”

“…As a matter of fact, EoE patients without GERD showed an earlier burning sensation than EoE patients with concomitant GERD or healthy volunteers after esophageal acid infusion [27]. Suppression of gastric acid secretion with PPIs, thus, might provide symptomatic relief even for patients with either normal or pathological esophageal acid exposure.…”