GERD
Conditions
Keywords
esophageal erosion, abnormal pH monitoring
Brief summary
GERD is a common condition in the western world. In most cases, the diagnostic is established by good response to empiric proton pump inhibitor (PPI) therapy. When the patient symptoms are refractory to therapy, multiple invasive tests are available. The results of those tests (EGD, manometry, Ph monitoring and impedance) are clues that the physician use together to establish the diagnostic. No test however can be use alone because of their poor specificity and sensitivity. Recently, microscopy has been used to detect dilated intercellular space in between distal esophageal cells tissue; unfortunately this marker again failed to diagnose GERD. In search of more sensitive and specific markers of GERD, we propose to assess if acid exposure affects: 1) gene and proteins expression in the esophageal/post-cricoid area tissue; and 2) local impedance of the mucosa. The secondary aim of this proposal is to determine if correlation exists between the two approaches.
Interventions
None listed
Sponsors
Vanderbilt University Medical Center
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(GERD Cases): * Male or female * Ages 18 years or older * Undergoing EGD as standard of care at Vanderbilt's Digestive Diseases Center * Esophageal erosion detected at EGD * Abnormal pH monitoring Inclusion Criteria (Controls): * Male or female * Ages 18 years or older * Undergoing EGD as standard of care at Vanderbilt's Digestive Diseases Center * No complaints or history o heartburn or acid regurgitation * No erosion at EGD * Normal pH monitoring
Exclusion criteria
* Less than 18 years of age * Unable to provide informed consent * Use of acid suppressive therapy within last 14 days * known history of Barrett's esophagus, gastric surgery, alcoholism, significant motility condition * contraindications to biopsy such as taking anticoagulants other than aspirin (coumadin, plavix) or allergies to local anesthetic
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in gene and protein expression due to acid exposure in the esophagus | Chronic exposure | We are assessing if acid exposure affects gene and protein expression in the esophageal/post-cricoid area tissue |
| Change in local impedance of the esophageal mucosa | Chronic exposure | We are assessing if acid exposure affects local impedance of the mucosa |
Countries
United States
Outcome results
None listed