Gastroesophageal reflux disease (GERD) is an important public health problem which is extremely common nowadays. Symptoms of GERD arise from the exposure of increased acid gastric contents into the lower part of the esophageal mucosa. Most patients with GERD have NERD with invisible mucosal damages under endoscopy. There is not a gold standard to diagnose NERD due to the poor sensitivity, specificity, and reproducibility of many existing methods. Dilated intercellular spaces (DIS) in the esophageal epithelium have been a recent research hotspot. DIS has been considered as a feature of esophageal epithelial damage induced by gastric acid reflux, and serves as a marker for new methods to diagnose NERD. Studies have highlighted the importance of refluxed gastric acid in esophageal epithelial DIS. Until now, the specificity of DIS has been questionable.
A research article to be published on March 7, 2010 in the World Journal of Gastroenterology addresses this question. The research team, led by Professor Zhou from Peking University Third Hospital, used transmission electron microscopy to evaluate the esophageal mucosal damages in response to various factors in rats, including acute stress, hydrochloric acid, ethanol, aspirin, and prednisolone.