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Stress-related changes in oesophageal permeability: filling the gaps of GORD?
  1. Johan D Söderholm
  1. Correspondence to:
    Professor Johan D Söderholm
    Department of Clinical and Experimental Medicine, Linköping University, Faculty of Health Sciences, SE-581 85 Linköping, Sweden; johda{at}


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 that mainly involve neuropeptides and mast cells. Moreover, accumulating evidence implicates increased permeability as a pathogenic factor in gastroesophageal reflux disease (GORD). 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 GORD.

  • CRH, corticotropin-releasing hormone
  • DIS, dilated intercellular spaces
  • GORD, gastroesophageal reflux disease
  • IBS, irritable bowel syndrome
  • NERD, non-erosive reflux disease
  • RMCPII, rat mast cell protease II
  • barrier function
  • corticotropin-releasing hormone
  • mast cells
  • psychological stress

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  • Published Online First 20 April 2007

  • Competing interests: None.