Oesophageal hypersensitivity in Japanese patients with non‐erosive gastro‐oesophageal reflux diseases

Miwa, Hiroto; Minoo, Toshoku; Hojo, Mariko; Yaginuma, Reiko; Nagahara, Akihito; Kawabe, Masato; Ohkawa, Akimitsu; Asaoka, Daisuke; Kurosawa, Akihiko; Ohkusa, Toshifumi; Sato, Nobuhiro

doi:10.1111/j.1365-2036.2004.01990.x

Cited by 78 publications

(77 citation statements)

References 32 publications

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“…In addition, sensory scores, which are the mathematical products of pain onset and pain levels, were significantly higher than healthy individuals. 24 These results indicate that sensitivity to intraesophageal acid stimulation is clearly higher in NERD patients than healthy individuals.…”

Section: Discussionsupporting

confidence: 54%

Intravenous Corticotropin-releasing Hormone Administration Increases Esophageal Electrical Sensitivity in Healthy Individuals

Yamasaki

Tomita

Takimoto

et al. 2017

J Neurogastroenterol Motil

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Background/AimsWhen a person is experiencing stress, corticotropin-releasing hormone (CRH) can modulate gut physiologies, such as visceral sensation or gastrointestinal motility, and its intravenous administration mimics stress-induced physiological changes. However, the influence of CRH on the esophagus is yet unknown. Accordingly, we investigated whether intravenous CRH administration increases esophageal sensitivity to electrical stimulation in healthy Japanese subjects. MethodsTwenty healthy subjects were recruited. We quantified the initial perception threshold (IPT) every 15 minutes after CRH injection. Venous blood was collected with a cannula, and both plasma adrenocorticotropic hormone (ACTH) and cortisol were measured at pre-stimulation, 0, 30, 60, 90, and 120 minutes. The results from each time point were compared against a baseline IPT obtained before electrical stimulation was initiated. ResultsWhen compared to the baseline IPT value (16.9 ± 4.5), CRH significantly decreased electrical threshold of the esophagus at 30, 45, 60, 75 minutes (14.1 ± 4.2, 13.1 ± 5.0, 12.1 ± 5.7, 14.0 ± 5.8 minutes, P < 0.01, respectively) after CRH injection, suggesting that CRH increased esophageal sensitivity to the electrical stimulus. CRH also significantly increased plasma ACTH levels at 30 minutes (50.3 ± 17.7, P < 0.01), and cortisol levels at 30 minutes (22.0 ± 6.7 minutes, P < 0.01) and 60 minutes (20.3 ± 6.7 minutes, P < 0.01) after CRH injection, when compared to the pre-stimulation ACTH and cortisol values. ConclusionIntravenous CRH administration increased esophageal electrical sensitivity in normal subjects, emphasizing the important role of stress in esophageal sensitivity.

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Section: Discussionsupporting

confidence: 54%

Intravenous Corticotropin-releasing Hormone Administration Increases Esophageal Electrical Sensitivity in Healthy Individuals

Yamasaki

Tomita

Takimoto

et al. 2017

J Neurogastroenterol Motil

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“…Some investigators have reported that patients with NERD show hypersensitivity of the esophagus to esophageal extension and acid perfusion [23,24] . Loose attachment between esophageal squamous cells is the most easily suspected cause of esophageal acid hypersensitivity.…”

Section: Discussionmentioning

confidence: 99%

Esophageal epithelial surface in patients with gastroesophageal reflux disease: An electron microscopic study

Azumi¹,

Adachi²,

Furuta³

et al. 2008

WJG

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AIM:To investigate the intercellular spaces between the most superficially located esophageal epithelial cells in patients with gastroesophageal reflux disease (GERD). METHODS: Eighteen patients with erosive esophagitis, 10 patients with non-erosive reflux disease (NERD), and 18 normal asymptomatic volunteers were enrolled. Biopsy specimens were obtained from the lower esophageal mucosa without ulcer or erosion. Scanning electron microscopy was employed to investigate the tightness of the superficial cellular attachment. RESULTS:The intercellular space between the most superficially located epithelial cells in patients with erosive esophagitis or NERD was not different from that in asymptomatic healthy individuals. CONCLUSION: Widened luminal intercellular spaces of esophageal superficial epithelium are not responsible for the induction of reflux symptoms in patients with GERD.

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“…GERD has a multifactorial pathogenesis, including the presence of gastric acid [1] or bile [2], hiatal hernia [3], lower esophageal sphincter (LES) dysfunction [3,4], esophageal motility dysfunction [4], impairment of esophageal epithelial resistance [5], and hypersensitivity [6]. Gastric acid in the reflux contents has major harmful effects on the esophageal mucosa and acid-suppressive drugs are effective in most cases of GERD [1].…”

Section: Introductionmentioning

confidence: 99%

“…Hiatal hernia and transient LES relaxation play a major role in abnormal gastroesophageal reflux (GER) [3,4]. Defensive factors such as esophageal clearance and epithelial resistance may be involved in the severity of GERD [4,6].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and clinical characteristics of GERD in the Japanese population

2009

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We reviewed articles on the epidemiology and clinical characteristics of gastroesophageal reflux disease (GERD) in Japan to clarify these features of GERD in this country. Although the definition of GERD depends on the individual study, the prevalence of GERD has been increasing since the end of the 1990s. The reasons for the increase in the prevalence of GERD may be due to increases in gastric acid secretion, a decrease in the Helicobacter pylori infection rate, more attention being paid to GERD, and advances in the concept of GERD. More than half of GERD patients had non-erosive reflux disease, and the majority (87%) of erosive esophagitis was mild type, such as Los Angeles classification grade A and grade B. There were several identified risk factors, such as older age, obesity, and hiatal hernia. In particular, mild gastric atrophy and absence of H. pylori infection influence the characteristics of GERD in the Japanese population. We also discuss GERD in the elderly; asymptomatic GERD; the natural history of GERD; and associations between GERD and peptic ulcer disease and H. pylori eradication. We examined the prevalence of GERD in patients with specific diseases, and found a higher prevalence of GERD, compared with that in the general population, in patients with diabetes mellitus, those with obstructive sleep apnea syndrome, and those with bronchial asthma. We provide a comprehensive review of GERD in the Japanese population and raise several clinical issues.

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Oesophageal hypersensitivity in Japanese patients with non‐erosive gastro‐oesophageal reflux diseases

Cited by 78 publications

References 32 publications

Intravenous Corticotropin-releasing Hormone Administration Increases Esophageal Electrical Sensitivity in Healthy Individuals

Intravenous Corticotropin-releasing Hormone Administration Increases Esophageal Electrical Sensitivity in Healthy Individuals

Esophageal epithelial surface in patients with gastroesophageal reflux disease: An electron microscopic study

Epidemiology and clinical characteristics of GERD in the Japanese population

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