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Oesophageal mucosal intercellular space diameter and reflux pattern in childhood erosive and non-erosive reflux

Valentina Mancini1, Mentore Ribolsi, Massimo Gentile

  • 1Division of Pediatric Gastroenterology and Hepatology, Sapienza University of Rome, Rome, Italy.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|September 15, 2012
PubMed

Insights

Dilated intercellular spaces in the esophagus are larger in children with gastro-esophageal reflux disease (GERD) compared to controls. This finding is consistent across both erosive and non-erosive GERD, regardless of acid exposure.

Area of Science:

  • Pediatric Gastroenterology
  • Gastroenterology
  • Pathology

Background:

  • Gastro-esophageal reflux disease (GERD) is common in children.
  • GERD is classified as erosive or non-erosive.
  • Intercellular space diameter is a potential marker for esophageal damage.

Purpose of the Study:

  • Compare intercellular space diameter in children with non-erosive GERD, erosive GERD, and controls.
  • Characterize reflux patterns in pediatric GERD phenotypes.
  • Explore the relationship between intercellular space diameter and reflux parameters.

Main Methods:

  • Prospective study of 24 children with non-erosive GERD, 20 with erosive GERD, and 10 controls.
  • Upper endoscopy with esophageal biopsies for transmission electron microscopy to measure intercellular space diameter.
  • Impedance-pH monitoring for reflux pattern analysis in GERD patients.

Main Results:

  • Mean intercellular space diameter was significantly higher in both non-erosive (0.9 ± 0.2 μm) and erosive GERD (1 ± 0.2 μm) compared to controls (0.5 ± 0.2 μm, p<0.01).
  • No significant difference in intercellular space diameter was found between non-erosive and erosive GERD groups.
  • Reflux parameters, including acid exposure time and reflux event counts, did not differ between patient groups and showed no correlation with intercellular space diameter.

Conclusions:

  • Dilated intercellular space diameter is a useful, objective marker of esophageal damage in pediatric GERD, irrespective of acid exposure.
  • Pediatric GERD phenotypes cannot be distinguished based on reflux patterns alone.
  • Further research may elucidate the role of intercellular space dilation in GERD pathogenesis.
Abstract

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