Effects of ursodeoxycholic acid in esophageal motility and the role of the mucosa. An experimental study

Authors


  • Author's contribution:

  • MSR: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, final approval of the version to be published.

  • FAH: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, final approval of the version to be published.

  • JCDG: review for intellectual content, final approval of the version to be published, ATF: review for intellectual content, final approval of the version to be published.

  • CT: acquisition of data, analysis and interpretation of data, final approval of the version to be published.

  • MGP: review for intellectual content, final approval of the version to be published.

  • Grant support:
    Dr Marcelo S. Rocha was supported by a federal governmental grant from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).

Dr Fernando A. M. Herbella, MD, ISDE member, Hospital Sao Paulo, Surgical Gastroenterology, Division of Esophagus and Stomach, Rua Diogo de Faria 1087 cj 301., Sao Paulo, SP 04037-003, Brazil. Email: herbella.dcir@epm.br

SUMMARY

Esophageal motor abnormalities are frequently found in patients with gastroesophageal reflux disease. The role of bile in reflux-induced dysmotility is still elusive. Furthermore, it is questionable weather mucosal or muscular stimulation leads to motor dysfunction. The aims of this study were to analyze (i) the effect of bile in the amplitude of esophageal contractions; and (ii) the effect of mucosal versus muscular stimulation. Eighteen guinea pig esophagi were isolated, and its contractility assessed with force transducers. Three groups were studied. In group A (n= 6), the entire esophagus was incubated in 100 µmL ursodeoxycholic acid for 1 hour; in group B (n= 6) the mucosal layer was removed and the muscular layer incubated in 100 µmL ursodeoxycholic acid for 1 hour; and in group C (n= 6) (control group) the entire esophagus was incubated in saline solution. In all groups, five sequential contractions induced by 40 mm KCl spaced by 5 minutes were measured before and after incubation. Contractions amplitudes before incubation were 1.319 g, 0.306 g, and 1.795 g, for groups A, B, and C, respectively. There were no differences between groups A and C (P= 0.633), but there were differences between groups A and B (P= 0.039), and B and C (P= 0.048). After incubation amplitude of contraction were 0.709 g, 0.278 g, and 1.353 g for groups A, B, and C, respectively. Only group A showed difference when pre and post-stimulation amplitudes were compared (P= 0.030). Our results show that (i) bile exposure decreases esophageal contraction amplitude; and (ii) the esophageal mucosa seems to play an important role in esophageal motility.

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