Previous thinking is being challenged as investigators attempt to learn more about the precipitating factors in the development of a condition that affects over 20% of the US population. In the past, it was believed that the direct chemical trauma caused by refluxed acid, pepsin, and bile resulted in the ‘burning’ sensation reported by GERD sufferers as related to their esophageal epithelium. However, a new (albeit, small) study has shown that rather than a contact injury as previously assumed, T lymphocyte–predominant esophageal inflammation and basal cell and papillary hyperplasia without loss of surface cells has been found in a large subset of the studied patients.
To make this make a bit clearer to the non-medical among us, GERD may not be coming from superficial damage to the surface epithelium; but rather, inflammation that has been percolating up from the basal layer of the esophageal tissue. So, those PPIs that have been prescribed may not be doing anything to help with that sour taste in your mouth following a large or high fat meal.
For more information, please see: http://jama.jamanetwork.com/article.aspx?articleid=2521970