Objective: To observe the changes of dilated intercellular space (DIS) of esophageal epithelium in different subtypes of gastroesophageal reflux disease (GERD) before and after esomeprazole treatment.
Methods: Nineteen patients with GERD, 6 with erosive esophagitis (EE), 7 with NERD with abnormal acid exposure (NERD pH+), and 6 with NERD with normal acid exposure (NERD pH-), were treated with esomeprazole 40 mg daily for two months. During endoscopy before and after treatment, six biopsy specimens were taken from the apparently normal mucosa 3 - 5 cm above the dentate line in the esophagus to undergo HE staining and histological examination and transmission electron microscopy (TEM). Fifteen normal subjects were used as controls.
Results: Two months after the treatment 5 cases (83.33%) in the EE group, 6 cases (85.57%) in the NERD pH+ group, and 5 cases (83.33%) in the NERD pH- group showed a complete recovery of DIS and complete disappearance of the symptom of heartburn. Two of the left three patients who showed incomplete recovery of DIS still had heartburn.
Conclusion: A complete recovery of DIS 2 months after treatment of esomeprazole is always accompanied by resolution of heartburn symptom. No significant difference in complete recovery of DIS can be found among different GERD subgroups.