Turning the Pathogenesis of Acute Peptic Esophagitis Inside Out

Here, Kahrilas comments on Dunbar and colleagues' report findings from a unique experiment in which they withdrew proton pump inhibitor (PPI) therapy from 12 patients with high-grade esophagitis whose esophageal erosions had been successfully treated by that therapy to observe the histopatholog...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2016-05, Vol.315 (19), p.2077-2078
Main Author: Kahrilas, Peter J
Format: Article
Language:English
Subjects:
Clinical outcomes
Drug therapy
Esophagitis, Peptic - pathology
Esophagus
Esophagus - pathology
Female
Gastroenterology
Gastroesophageal reflux
Gastroesophageal Reflux - pathology
Humans
Inhibitor drugs
Male
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Summary:Here, Kahrilas comments on Dunbar and colleagues' report findings from a unique experiment in which they withdrew proton pump inhibitor (PPI) therapy from 12 patients with high-grade esophagitis whose esophageal erosions had been successfully treated by that therapy to observe the histopathological events leading to acute (recurrent) peptic esophagitis. Among other things, within 2 weeks, 11 of the patients had developed recurrent erosive esophagitis as well as a substantial worsening of reflux symptoms. All of the classic histopathological findings and physiological consequences of gastroesophageal reflux disease were reproduced: basal cell hyperplasia, papillary elongation, and dilated intercellular spaces in the esophageal squamous cell epithelium; increased distal esophageal acid exposure and reduced mucosal impedance on reflux monitoring studies.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2016.5827