A new study at UT Southwestern Medical Center, supported by the Dallas VA Medical Center and the National Institutes of Health and reported in the November issue of Gastroenterology shows that gastroesophageal reflux disorder (GERD) may actually be an autoimmune disorder. The study showed that damage to the esophagus that occurs as a result of GERD is not from stomach acid but chemicals called cytokines which are released by esophageal cells in response to GERD.
The study was performed on rats. Researchers conducted surgery on the rats where they connected the duodenum (part of the intestine) to the esophagus to create similar conditions of GERD where stomach acid and bile were frequently spilling into the esophagus. Instead of appearing immediately as you would expect if stomach acid was the culprit of esophageal damage, damage to the esophagus did not appear for a number of weeks. "That doesn't make sense if GERD is really the result of an acid burn, as we all were taught in medical school," said Dr. Stuart Spechler, professor of internal medicine at UT Southwestern and senior author of the study. "Chemical injuries develop immediately. If you spill battery acid on your hand, you don't have to wait a month to see the damage."
"In animal models of reflux esophagitis designed to mimic the human disease, researchers hadn't looked at the early events in the development of esophageal injury," Dr. Souza, staff physician at the Dallas Veterans Affairs Medical Center and part of the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern noted. "Most of those investigators have been interested in the long-term consequences of GERD, and we found virtually no published data about what happens later that induces gastroesophageal reflux."
Three days after the surgery researchers expected to see damage to the surface cells of the esophagus. Instead they found damage to cells deep within the tissue of the esophagus. GERD can cause sore throat, chest pain, and over time esophageal cancer. Similar studies will have to be preformed on humans to verify the results of this study. You can read more about this study on Newswise.
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