GERD Injury May Have Immune Trigger

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In a study published in Gastroenterology, researchers discovered that stomach acid may only be one factor contributing to injury from reflux esophagitis in people who suffer from gastroesophageal reflux disease (GERD).

Until this study, it was assumed that stomach acid burned and damaged the cells in the lining of the esophagus, directly causing reflux esophagitis. However, using a rat model of GERD, scientists discovered that the reflux of the stomach acid actually triggered the release of chemicals called cytokines. These chemicals attract inflammatory immune cells to the esophagus, causing damage.

Researchers found that the damage to the lining of the esophagus occurred weeks after the exposure to stomach acids, not immediately after. Stuart Spechler, MD, professor of internal medicine at the University of Texas Southwestern Medical Center, said “that doesn’t make sense if GERD is really the result of an acid burn. Chemical injuries develop immediately. If you spill battery acid on your hand, you don’t have to wait a month to see the damage.”

If these results can be confirmed with human subjects, new treatments for GERD may be required for effective disease management. Rhonda Souza, MD, said that the current treatment of GERD is to prescribe medications that prevent your stomach from making acid, but that “maybe we should create medications that would prevent these cytokines from attracting inflammatory cells to the esophagus and starting the injury in the first place.”

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