Changes of intercellular spaces of esophageal epithelium in patients with gastroesophageal reflux disease before and after esomeprazole treatment

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.