Increased esophageal mucosal/submucosal blood flow in patients with gastroesophageal reflux disease: normalization by treatment with a proton pump inhibitor.
OBJECTIVE
Mucosal injury caused by gastroesophageal reflux may result in changes in esophageal mucosal blood flow. Little is known about esophageal mucosal blood flow in patients with gastroesophageal reflux disease (GERD). Here we examined esophageal mucosal blood flow and the effects of treatment in patients with GERD.


METHODS
The subjects included 41 cases (21 males and 20 females, mean age 64.2 years) in whom endoscopy was warranted in patients complaining of heartburn and/or regurgitation. We also studied six normal control subjects. Patients underwent endoscopy, laser Doppler flow meter measurements, and endoscopic ultrasonography before and after treatment.


RESULTS
Esophageal mucosal/submucosal blood flow was increased in patients with GERD compared with the control patients. The thickness of the whole esophageal wall and that of the mucosal and submucosal layers of the esophagus correlated significantly with esophageal mucosal/submucosal blood flow. The increased esophageal mucosal/submucosal blood flow significantly decreased after 4 weeks' treatment with lansoprazole, a proton pump inhibitor.


CONCLUSIONS
Our results indicated that the pathophysiology or underlying mechanisms of GERD includes increased esophageal mucosal/submucosal blood flow, which correlates with the thickness of the esophageal wall, but is reversible and responds to treatment with lansoprazole. This suggests that proton pump inhibitors can effectively treat GERD and promote histological normalization of the mucosa and submucosa in the lower esophagus.
Mine
Shinichiro
S
The Department of Internal Medicine, Hagiwara Central Hospital, Kitakyushu, Fukuoka, Japan. s-mine@med.uoeh-u.ac.jp
Iida
Takeshi
T
Tabata
Takahiro
T
Okada
Yosuke
Y
Tanaka
Yoshiya
Y
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D004947:Esophagus / Q000098:blood supply* / Q000187:drug effects / Q000473:pathology; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D064747:Lansoprazole; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000098:blood supply* / Q000187:drug effects / Q000473:pathology; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012039:Regional Blood Flow / Q000187:drug effects; D011795:Surveys and Questionnaires; D014463:Ultrasonography
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D015738:Famotidine