Dilated intercellular spaces as a marker of GERD.

Journal Article (Journal Article;Review)

Gastroesophageal reflux disease (GERD) is typically heralded by the substernal burning pain of heartburn. On endoscopic examination, about one third of GERD subjects with heartburn have erosive disease, and the remainder have nonerosive reflux disease (NERD). Unlike patients with erosive disease, those with NERD (approximately 50%) often do not respond to therapy with proton pump inhibitors (PPIs), raising the question of whether they have NERD and, if they do, whether the cause of their symptoms is similar to those who respond to PPIs. Recently, biopsies established that subjects with heartburn and PPI-responsive NERD, like those with erosive esophagitis, have lesions within the esophageal epithelium known as dilated intercellular space (DIS). In this article, we discuss the physicochemical basis for DIS in acid-injured esophageal epithelium and its significance in GERD. Although DIS is not pathognomic of GERD, it is a marker of a break in the epithelial (junctional) barrier reflecting an increase in paracellular permeability.

Full Text

Duke Authors

Cited Authors

  • Orlando, LA; Orlando, RC

Published Date

  • June 2009

Published In

Volume / Issue

  • 11 / 3

Start / End Page

  • 190 - 194

PubMed ID

  • 19463218

Pubmed Central ID

  • 19463218

Electronic International Standard Serial Number (EISSN)

  • 1534-312X

Digital Object Identifier (DOI)

  • 10.1007/s11894-009-0030-6


  • eng

Conference Location

  • United States