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The most recent version of this article was published on 1 September 2007

Gut. Published Online First: 20 April 2007. doi:10.1136/gut.2007.120691
Copyright © 2007 BMJ Publishing Group Ltd & British Society of Gastroenterology.

Leading Article (commissioned only)

Stress related changes in oesphageal permeability - filling the gaps of GORD?

Johan D Söderholm 1*

1 University Hospital Linkoping, Sweden

* To whom correspondence should be addressed. E-mail: johda{at}ibk.liu.se.

Accepted 12 April 2007


Abstract

Albeit remaining a controversial issue, it has become increasingly recognised that psychological stress has a major impact on gut mucosal function and affects the course of gastrointestinal disorders. Research during the last decade has shown that stress causes barrier dysfunction of the gastrointestinal mucosa by mechanisms mainly involving neuropeptides and mast cells. Moreover, accumulating evidence implicates increased permeability as a pathogenic factor in gastro-oesophageal reflux disease. Recent data demonstrating that psychological stress may induce a permeability defect in stratified epithelia, including the oesophagus, shed new light on the pathophysiological events leading to heartburn and reflux disease, and give clues to additional therapeutic approaches.

Keywords: barrier function, corticotropin-releasing hormone, mast cells, psychological stress


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