Characterized by a burning sensation in the chest and throat, difficulty swallowing, sore throat, a dry cough, and regurgitation of food or sour liquid, gastroesophageal reflux disease (GERD) is a chronic digestive issue that affects 20 to 30 percent of the population weekly. It’s been thought that stomach acid backs up into the esophagus, causing damage to the lining of it in those who suffer from the condition. However, researchers at the University of Texas Southwestern Medical Center and Dallas VA Medical Center have found that it is an inflammatory response created by the secretion of proteins called cytokines. Cytokines act as a molecular messenger between cells, regulating several inflammatory responses through interaction with the immune system. Inflammation occurs when there’s an infection or condition present like GERD.
Researchers from the Texas-based study, Dr. Spechler and Dr. Souza, examined patients who have been successfully treated for reflux esophagitis with medicines called proton pump inhibitors (PPIs). Common PPI-containing medications are Prilosec, Prevacid, and Zegerid—all of which are available OTC. The researchers thought that GERD would reoccur if PPIs were stopped, allowing for early symptoms of GERD. Their hypothesis was correct because the patients experienced changes in the esophagus. These changes did not resemble a chemical burn, giving the researchers the notion that refluxed stomach acid triggers the esophagus to develop cytokines, thus resulting in inflammation. Dr. Spechler says, “A chemical burn should develop immediately, as it does if you spill battery acid on your hand.”
This new study challenges some of the long-held beliefs of GERD and how to treat it in years to come. “Someday we might treat GERD with medications that target the cytokines or inflammatory cells that really cause the damage to the esophagus,” says Dr. Souza.