Document Detail


The integrity of the esophageal mucosa. Balance between offensive and defensive mechanisms.
MedLine Citation:
PMID:  21126700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heartburn is the most common and characteristic symptom of gastroesophageal reflux disease. It ultimately results from contact of refluxed gastric acid with nociceptors within the esophageal mucosa and transmission of this peripheral signal to the central nervous system for cognition. Healthy esophageal epithelium provides an effective barrier between refluxed gastric acid and esophageal nociceptors; but this barrier is vulnerable to attack and damage, particularly by acidic gastric contents. How gastric acid is countered by defensive elements within the esophageal mucosa is a major focus of this discussion. When the defense is successful, the subject is asymptomatic and when unsuccessful, the subject experiences heartburn. Those with heartburn commonly fall into one of three endoscopic types: nonerosive reflux disease, erosive esophagitis and Barrett's esophagus. Although what determines endoscopic type remains unknown; it is proposed herein that inflammation plays a key, modulating role.
Authors:
Roy C Orlando
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Best practice & research. Clinical gastroenterology     Volume:  24     ISSN:  1532-1916     ISO Abbreviation:  Best Pract Res Clin Gastroenterol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  2011-03-21     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  101120605     Medline TA:  Best Pract Res Clin Gastroenterol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  873-82     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Affiliation:
University of North Carolina at Chapel Hill, 27599, USA. rorlando@med.unc.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Barrett Esophagus / etiology,  metabolism*,  pathology,  physiopathology
Biological Transport
Endoscopy, Gastrointestinal
Esophagitis / etiology,  metabolism*,  pathology,  physiopathology
Esophagus / blood supply,  metabolism*,  pathology,  physiopathology
Gastric Acid / metabolism*
Gastroesophageal Reflux / complications,  metabolism*,  pathology,  physiopathology
Heartburn / etiology,  metabolism
Humans
Mucous Membrane / metabolism
Permeability
Regional Blood Flow
Grant Support
ID/Acronym/Agency:
R37 DK036013-22/DK/NIDDK NIH HHS

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