Busting a Myth About Esophageal Health

Gastroesophageal Reflux Diseases, or GERD, is a common disorder that affects up to 20 percent of Americans. In more severe cases it can lead to bleeding ulcers in the esophagus that can be associated with a condition called Barrett’s esophagus, which increases the risk of cancer.

For nearly a century it has been believed that the damage to the esophagus caused by GERD was due to stomach acid backing up through the esophagus and essentially burning the lining. New preliminary research now indicates that the damage may be associated with an inflammatory response, not a chemical burn.

Researchers analyzed 12 patients with reflux esophagitis (damage to the lining of the esophagus) that had been successfully treated with proton pump inhibitors (PPIs). The researchers hypothesized that stopping the PPIs would result in redevelopment of GERD and would allow them to observe the very early stages of the disease. As they suspected, esophagitis reoccurred in 11 out of 12 patients. After analyzing tissue samples, it was evident that the damage to the esophagus was related to inflammation and not damage to the surface or lining of the esophagus.

The findings build on previous animal research and support the new idea that refluxed stomach acid stimulates the esophagus to secrete proteins called cytokines, which begins the process of inflammation. While PPIs will continue to be used as an effective treatment against esophagitis, the new research, if replicated, may result in new and novel approaches to the treatment of this disease.

Dunbar KB, Agoston AT, Odze RD, et al. Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes. JAMA. 2016;315(19):2104-12.