Experimental study of acid burden and acute oesophagitis

K. G. Pursnani, M. A. Mohiuddin, K. R. Geisinger, G. Weinbaum, David A Katzka, D. O. Castell

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: The relationship of the pH of oesophageal refluxate and its pepsin content to injury of oesophageal mucosa remains unclear. A study was made of the earliest morphological alterations in the oesophageal mucosa secondary to varying concentrations of hydrochloric acid with or without pepsin. Methods: Adult cats had varying concentrations of acid with and without 1 per cent porcine pepsin infused into the oesophagus through a paediatric feeding tube placed 5 cm above the oesophagogastric junction at a rate of 1 ml/min for 30 min. At autopsy 24 h later, the oesophagus was removed intact and scored by an expanded modification of a previously published histopathological scoring system. This included estimates of the intensity and distribution of four morphological features: basal cell hyperplasia (BCH), intraepithelial leucocytes (IELs), subepithelial leucocytes and ulcers. Each of these four categories was scored from 0 to 4, with a maximum injury score of 16. Results: Mean (s.e.m.) scores were as follows: pH 1, 15-0(1.0); pH 1 with pepsin, 13-3(1.4); pH 2, 15.3(0.7); pH 2 with pepsin, 11.7(1.1); pH 3, 1.8(1.6); pH 3 with pepsin, 3.7(1.9); pH 4 with or without pepsin, 0.6(0.2). Differences between pH 3 and 4 versus pH 1 and 2 were significant (P < 0.05). Conclusion: Injury to the oesophagus is more dependent on the pH of refluxate than on the presence of pepsin. Peptic injury appears to occur at a critical threshold of acid burden (pH < 3) as opposed to a graded level of injury based on a pH scale.

Original languageEnglish (US)
Pages (from-to)677-680
Number of pages4
JournalBritish Journal of Surgery
Volume85
Issue number5
DOIs
StatePublished - 1998
Externally publishedYes

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Esophagitis
Pepsin A
Acids
Esophagus
Wounds and Injuries
Leukocytes
Esophagogastric Junction
Hydrochloric Acid
Enteral Nutrition
Ulcer
Hyperplasia
Digestion
Autopsy
Cats
Swine

ASJC Scopus subject areas

  • Surgery

Cite this

Pursnani, K. G., Mohiuddin, M. A., Geisinger, K. R., Weinbaum, G., Katzka, D. A., & Castell, D. O. (1998). Experimental study of acid burden and acute oesophagitis. British Journal of Surgery, 85(5), 677-680. https://doi.org/10.1046/j.1365-2168.1998.00687.x

Experimental study of acid burden and acute oesophagitis. / Pursnani, K. G.; Mohiuddin, M. A.; Geisinger, K. R.; Weinbaum, G.; Katzka, David A; Castell, D. O.

In: British Journal of Surgery, Vol. 85, No. 5, 1998, p. 677-680.

Research output: Contribution to journalArticle

Pursnani, KG, Mohiuddin, MA, Geisinger, KR, Weinbaum, G, Katzka, DA & Castell, DO 1998, 'Experimental study of acid burden and acute oesophagitis', British Journal of Surgery, vol. 85, no. 5, pp. 677-680. https://doi.org/10.1046/j.1365-2168.1998.00687.x
Pursnani, K. G. ; Mohiuddin, M. A. ; Geisinger, K. R. ; Weinbaum, G. ; Katzka, David A ; Castell, D. O. / Experimental study of acid burden and acute oesophagitis. In: British Journal of Surgery. 1998 ; Vol. 85, No. 5. pp. 677-680.
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