Esophageal physiology-an overview of esophageal disorders from a pathophysiological point of view

Evaluation of the impact of oesophageal reflux disease on muscle fatigue

Gastroesophageal reflux disease (GERD) is a gastrointestinal tract disorder associated with regurgitation of gastric acid into the oesophagus. It can present itself as non-erosive reflux condition or erosive esophagitis. Our main objective was to evaluate the impact of oesophageal reflux disease on muscle fatigue among patients. The prospective study design was adopted using surveys performed at the South West China Medical University. All patients who were subjected to screening endoscopy at the South West China Medical University were prospectively enrolled in the study. Our study was conducted according to ethical guidelines involving animal and human subjects. Our study used Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), and the Multidimensional Fatigue Inventory (MFI) questionnaires to perform data collection on the levels of fatigue, depression, daytime hypersomnolence and anxiety. In the (HADS, Anxiety (β = 0.657, p < .001) and Depression (β = 2.927, p < .001) exhibited significant positive associations with the predicted fatigue. The Epworth Sleepiness Scale (ESS) showed no significant difference between individuals with and without reflux esophagitis (p = 0.787, power = 0.071). However, a significant difference was observed based on the presence of GERD symptoms (p = 0.003, power = 0.789), with higher mean scores for those with GERD symptoms (6.1±3.5) compared to those without (4.9±2.9). In MFI, significant differences were observed between the two groups for General and Physical Fatigue (p = 0.040, power = 0.823), Mental Fatigue (p = 0.002, power = 0.767), and MFI Total Score (p = 0.002, power = 0.981). In conclusion, GERD symptoms exhibited stronger associations with fatigue and daytime sleepiness than endoscopic findings, emphasizing the impact of symptomatic experiences on well-being.

The occurrence and development mechanisms of esophageal stricture: state of the art review

BACKGROUND

Esophageal strictures significantly impair patient quality of life and present a therapeutic challenge, particularly due to the high recurrence post-ESD/EMR. Current treatments manage symptoms rather than addressing the disease's etiology. This review concentrates on the mechanisms of esophageal stricture formation and recurrence, seeking to highlight areas for potential therapeutic intervention.

METHODS

A literature search was conducted through PUBMED using search terms: esophageal stricture, mucosal resection, submucosal dissection. Relevant articles were identified through manual review with reference lists reviewed for additional articles.

RESULTS

Preclinical studies and data from animal studies suggest that the mechanisms that may lead to esophageal stricture include overdifferentiation of fibroblasts, inflammatory response that is not healed in time, impaired epithelial barrier function, and multimethod factors leading to it. Dysfunction of the epithelial barrier may be the initiating mechanism for esophageal stricture. Achieving perfect in-epithelialization by tissue-engineered fabrication of cell patches has been shown to be effective in the treatment and prevention of esophageal strictures.

CONCLUSION

The development of esophageal stricture involves three stages: structural damage to the esophageal epithelial barrier (EEB), chronic inflammation, and severe fibrosis, in which dysfunction or damage to the EEB is the initiating mechanism leading to esophageal stricture. Re-epithelialization is essential for the treatment and prevention of esophageal stricture. This information will help clinicians or scientists to develop effective techniques to treat esophageal stricture in the future.