Biology in Patients With Reflux Esophagitis
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Gastroesophageal Reflux Disease , Gastrointestinal |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | November 2010 |
| End Date: | December 2016 |
Biology in Patients With Reflux Esophagitis and Mucosal Impedance
GERD is a common condition in the western world. In most cases, the diagnostic is
established by good response to empiric proton pump inhibitor (PPI) therapy. When the
patient symptoms are refractory to therapy, multiple invasive tests are available. The
results of those tests (EGD, manometry, Ph monitoring and impedance) are clues that the
physician use together to establish the diagnostic. No test however can be use alone because
of their poor specificity and sensitivity. Recently, microscopy has been used to detect
dilated intercellular space in between distal esophageal cells tissue; unfortunately this
marker again failed to diagnose GERD.
In search of more sensitive and specific markers of GERD, we propose to assess if acid
exposure affects: 1) gene and proteins expression in the esophageal/post-cricoid area
tissue; and 2) local impedance of the mucosa. The secondary aim of this proposal is to
determine if correlation exists between the two approaches.
established by good response to empiric proton pump inhibitor (PPI) therapy. When the
patient symptoms are refractory to therapy, multiple invasive tests are available. The
results of those tests (EGD, manometry, Ph monitoring and impedance) are clues that the
physician use together to establish the diagnostic. No test however can be use alone because
of their poor specificity and sensitivity. Recently, microscopy has been used to detect
dilated intercellular space in between distal esophageal cells tissue; unfortunately this
marker again failed to diagnose GERD.
In search of more sensitive and specific markers of GERD, we propose to assess if acid
exposure affects: 1) gene and proteins expression in the esophageal/post-cricoid area
tissue; and 2) local impedance of the mucosa. The secondary aim of this proposal is to
determine if correlation exists between the two approaches.
Inclusion Criteria (GERD Cases):
- Male or female
- Ages 18 years or older
- Undergoing EGD as standard of care at Vanderbilt's Digestive Diseases Center
- Esophageal erosion detected at EGD
- Abnormal pH monitoring
Inclusion Criteria (Controls):
- Male or female
- Ages 18 years or older
- Undergoing EGD as standard of care at Vanderbilt's Digestive Diseases Center
- No complaints or history o heartburn or acid regurgitation
- No erosion at EGD
- Normal pH monitoring
Exclusion Criteria:
- Less than 18 years of age
- Unable to provide informed consent
- Use of acid suppressive therapy within last 14 days
- known history of Barrett's esophagus, gastric surgery, alcoholism, significant
motility condition
- contraindications to biopsy such as taking anticoagulants other than aspirin
(coumadin, plavix) or allergies to local anesthetic
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