Effect of intermittent acid and pepsin exposure on burned esophageal mucosa

Abstract

Purpose: To determine if gastroesophageal reflux affects the healing of esophageal mucosa damaged by alkaline substances.

Materials and methods: In a rabbit model, the effects of intermittent acid and pepsin exposure (thereby mimicking gastroesophageal reflux) on post-caustic-burn esophageal mucosa were examined. Exposures were group I (n = 9), sodium hydroxide exposure alone; group II (n = 9), daily acid and pepsin exposure; and group III (n = 8), sodium hydroxide, then daily acid and pepsin exposure. After 3 weeks, the animals were killed and their esophagi examined.

Results: Grossly, specimens in group II appeared normal; specimens in groups I and III were abnormal, displaying some scar tissue, but were not significantly different. Histologically, the differences between groups I and III approached significance. Increased numbers of intraepithelial eosinophils were seen in those specimens exposed to reflux.

Conclusions: Gastroesophageal reflux may retard the healing of injured esophageal mucosa and should be studied further in an effort to improve the care of patients who sustain alkaline esophageal burns.