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Review article: role of pepsin and bile in gastro-oesophageal reflux disease.
Aliment Pharmacol Ther. 2005 Aug; 22 Suppl 1:48-54.AP

Abstract

Gastro-oesophageal reflux disease is defined as the presence of symptoms or lesions that can be attributed to the reflux of gastric contents into the oesophagus. Aspiration and prolonged monitoring studies in humans have shown that reflux of gastric contents is comprised of both acid and non-acid components, in healthy as well as diseased people. Methods to monitor the non-acid component of the refluxate are described in detail. Experimental models suggest that synergism between acid and pepsin and conjugated bile acids have the greatest damaging potential for oesophageal mucosa, although unconjugated bile acids may be caustic at a more neutral pH. Human studies are compatible with a synergistic action between acid and duodenogastric reflux in inducing lesions. During prolonged monitoring studies, typical gastro-oesophageal reflux disease symptoms are more related to acid reflux events than to non-acid reflux events. However, symptoms that persist during acid-suppressive therapy are often related to non-acid reflux events. The therapeutic options for the non-acid component of the refluxate, including acid suppression, prokinetics, baclofen and surgery, are discussed.

Authors+Show Affiliations

Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium. jan.tack@med.kuleuven.ac.be

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16042659

Citation

Tack, J. "Review Article: Role of Pepsin and Bile in Gastro-oesophageal Reflux Disease." Alimentary Pharmacology & Therapeutics, vol. 22 Suppl 1, 2005, pp. 48-54.
Tack J. Review article: role of pepsin and bile in gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2005;22 Suppl 1:48-54.
Tack, J. (2005). Review article: role of pepsin and bile in gastro-oesophageal reflux disease. Alimentary Pharmacology & Therapeutics, 22 Suppl 1, 48-54.
Tack J. Review Article: Role of Pepsin and Bile in Gastro-oesophageal Reflux Disease. Aliment Pharmacol Ther. 2005;22 Suppl 1:48-54. PubMed PMID: 16042659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: role of pepsin and bile in gastro-oesophageal reflux disease. A1 - Tack,J, PY - 2005/7/27/pubmed PY - 2005/12/20/medline PY - 2005/7/27/entrez SP - 48 EP - 54 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 22 Suppl 1 N2 - Gastro-oesophageal reflux disease is defined as the presence of symptoms or lesions that can be attributed to the reflux of gastric contents into the oesophagus. Aspiration and prolonged monitoring studies in humans have shown that reflux of gastric contents is comprised of both acid and non-acid components, in healthy as well as diseased people. Methods to monitor the non-acid component of the refluxate are described in detail. Experimental models suggest that synergism between acid and pepsin and conjugated bile acids have the greatest damaging potential for oesophageal mucosa, although unconjugated bile acids may be caustic at a more neutral pH. Human studies are compatible with a synergistic action between acid and duodenogastric reflux in inducing lesions. During prolonged monitoring studies, typical gastro-oesophageal reflux disease symptoms are more related to acid reflux events than to non-acid reflux events. However, symptoms that persist during acid-suppressive therapy are often related to non-acid reflux events. The therapeutic options for the non-acid component of the refluxate, including acid suppression, prokinetics, baclofen and surgery, are discussed. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/16042659/Review_article:_role_of_pepsin_and_bile_in_gastro_oesophageal_reflux_disease_ L2 - https://doi.org/10.1111/j.1365-2036.2005.02609.x DB - PRIME DP - Unbound Medicine ER -