Visceral hypersensitivity in non-erosive reflux disease

Knowles, Charles H.; Aziz, Qasim

doi:10.1136/gut.2007.127886

Cited by 167 publications

(139 citation statements)

References 108 publications

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“…Three possible mechanisms are associated with visceral hypersensitivity: peripheral sensitization, central sensitization, and psychoneuroimmune interactions. 67 Depression and anxiety are more common in women than in men in the general population. [88][89][90] The prevalence of NERD is also more common in women.…”

Section: Psychological Factorsmentioning

confidence: 99%

“…65,66 TRPV1 may lead to visceral hypersensitivity as one of the important factors in the pathogenesis of NERD. 67 It has been hypothesized that TRPV1 activation could trigger inflammation by releasing substance P and calcitonin-gene-related peptide in primary afferent neurons. 68 Therefore, up-regulation of TRPV1 expression in the esophageal mucosa might be the underlying mechanism of the visceral hypersensitivity in NERD.…”

Section: Esophageal Nociceptionmentioning

confidence: 99%

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Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

125

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It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s. The mean age of EAC incidence in women is higher than in men, suggesting a role of estrogen in delaying the onset of BE and EAC. In a chronic rat reflux esophagitis model, nitric oxide was found to be an aggravating factor of esophageal injury in a male-predominant way. In addition, the expression of esophageal occludin, a tight junction protein that plays an important role in the esophageal defense mechanism, was up-regulated in women. This explains the male predominance of reflux esophagitis and delayed incidence of BE or EAC in women. Moreover, the symptoms such as heartburn, regurgitation, and extra-esophageal symptoms have been more frequently reported by women than by men, suggesting that sex and gender play a role in symptom perception. Differential sensitivity with augmented symptoms in women might have diagnostic and therapeutic influence. Furthermore, recent studies have suggested that hormone replacement therapy has a protective effect against esophageal cancer. However, an anti-inflammatory role of estrogen remains compelling, which means further study is necessary in this area.

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Section: Psychological Factorsmentioning

confidence: 99%

Section: Esophageal Nociceptionmentioning

confidence: 99%

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

125

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“…Psychological intervention can improve the general well-being and quality of life of patients with GI symptoms and also influence the outcome of medical and surgical treatment [11]. Tricyclic antidepressants and selective serotonin reuptake inhibitors have shown to improve visceral analgesic effect in esophageal pain in patients with non-cardiac chest pain [12]. Antidepressants reduce or relieve psychological and mental factors, which are known to be capable of inducing FD, GERD, NERD symptoms.…”

Section: Need Of Psychological Interventionmentioning

confidence: 99%

Anxiety Induced Refractory Gastrointestinal Disorders

Faruqui¹

2017

JLRDT

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Million suffer from acid related disorders with little respite without treatment. Today progress made has given us a quantum leap in understanding the disease and this has translated into the development of effective treatment. Right from the use of antacids which dominated the treatment arena in the last century to the discovery of Histamine-2-receptor antagonists towards the second half of the last century, progress has been constant over the decades. Today the benefits of the PPIs (proton pump inhibitors) have percolated to countless people across the globe. At no point in history were acid disorders this effectively managed. Furthermore, the relationship between anxiety and heartburn is not an obvious one. Many of the patients that suffer from heartburn when they have anxiety already had GERD (gastroesophageal reflux disorder). However, GERD patients with psychological comorbidity tend to seek medical assistance for their acid reflux earlier than patients without comorbidity, probably due to anxiety, concern over painful symptoms and depression, prompting scientist to dwell on the approach forward. Lead by observations that are based on recent data about the contribution of psychological comorbidity to the PPI failure phenomenon, GERD patients who are not responsive to treatment should be evaluated for psychological comorbidity.Keywords: Histamine-2-receptor; GERD patients; PPI; Inflammatory reactions; Clinical condition

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“…40 Nerve growth factor acting on tropomyosin receptor kinase A (TrkA) receptors could also up-regulate of TRPV1 expression. 41,42 Moreover, sustained inflammation, including MCs mediators, have the common effect of reducing the transduction threshold of ion channels on the peripheral terminals of nociceptors, such as TRPV1. 41 In this sense, MCs play an important role in neural plasiticity in the gut and maintain the hyperexcitability of nociceptors.…”

Section: Mast Cells Modulate Visceral Sensationmentioning

confidence: 99%

Mast Cells and Irritable Bowel Syndrome: From the Bench to the Bedside

Zhang

Song

Hou

2016

J Neurogastroenterol Motil

111

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Irritable bowel syndrome (IBS) is traditionally defined as a functional disorder since it lacks demonstrable pathological abnormalities. However, in recent years, low grade inflammatory infiltration, often rich in mast cells, in both the small and large bowel, has been observed in some patients with IBS. The close association of mast cells with major intestinal functions, such as epithelial secretion and permeability, neuroimmune interactions, visceral sensation, and peristalsis, makes researchers and gastroenterologists to focus attention on the key roles of mast cells in the pathogenesis of IBS. Numerous studies have been carried out to identify the mechanisms in the development, infiltration, activation, and degranulation of intestinal mast cells, as well as the actions of mast cells in the processes of mucosal barrier disruption, mucosal immune dysregulation, visceral hypersensitivity, dysmotility, and local and central stress in IBS. Moreover, therapies targeting mast cells, such as mast cell stabilizers (cromoglycate and ketotifen) and antagonists of histamine and serotonin receptors, have been tried in IBS patients, and have partially exhibited considerable efficacy. This review focuses on recent advances in the role of mast cells in IBS, with particular emphasis on bridging experimental data with clinical therapeutics for IBS patients.

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Visceral hypersensitivity in non-erosive reflux disease

Cited by 167 publications

References 108 publications

Sex and Gender Differences in Gastroesophageal Reflux Disease

Sex and Gender Differences in Gastroesophageal Reflux Disease

Anxiety Induced Refractory Gastrointestinal Disorders

Mast Cells and Irritable Bowel Syndrome: From the Bench to the Bedside

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