OESOPHAGEAL EPITHELIAL PROTECTIVE MECHANISMS AGAINST ACID REFLUX

The basis of the resistance of oesophageal squamous epithelium to acid injury is unknown. In this issue, Tanaka and colleagues investigated this, measuring oesophageal mucosal blood flow using a laser doppler probe while simultaneously imaging the oesophageal mucosa using a fluorescence microscope and a pH-sensitive fluorescent dye to asses the interstitial pH. Using these techniques, they were able to show that the oesophageal mucosa was able to exclude an acid solution of pH 1.5 without any change of the interstitial pH while exposing the serosal layer to a mildly acidic solution rapidly produced acidification of the interstitial space. However, the most striking effect was an increase in blood flow in the oesophageal mucosa which is likely to be protective.

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NON-INVASIVE SCREENING TESTS FOR H PYLORI INFECTION IN CHILDREN

Since Helicobacter infection is acquired in early childhood, it is logical to detect and treat it then. However, at the age when infection occurs toddlers are easily traumatised by medical investigations. Even the urea breath test can be difficult for a child. A stool test would circumvent all these problems and might have considerable appeal both for research and clinical practice. Koletzko et al studied 302 symptomatic children, testing …