EFFECT OF INTERMITTENT ACID AND PEPSIN EXPOSURE ON BURNED ESOPHAGEAL MUCOSE

Purpose: To determine if gastroesophageal reflux affects the healing o f esophageal mucosa damaged by alkaline substances. Materials and Meth ods: In a rabbit model, the effects of intermittent acid and pepsin ex posure (thereby mimicking gastroesophageal reflux) on post-caustic-bur n esophageal mucosa were examined. Exposures were group I (n = 9), sod ium hydroxide exposure alone; group II (n = 9), daily acid and pepsin exposure; and group III (n = 8), sodium hydroxide, then daily acid and pepsin exposure. After 3 weeks, the animals were killed and their eso phagi examined. Results: Grossly, specimens in group II appeared norma l; specimens in groups I and III were abnormal, displaying some scar t issue, but were not significantly different. Histologically, the diffe rences between groups I and III approached significance. Increased num bers of intraepithelial eosinophils were seen in those specimens expos ed to reflux. Conclusions: Gastroesophageal reflux may retard the heal ing of injured esophageal mucosa and should be studied further in an e ffort to improve the care of patients who sustain alkaline esophageal burns. (C) 1996 by W.B. Saunders Company.