GERD induced injury to esophageal mucosa, can we detect mucosal derangement non-invasively by stool analysis
Have you tried fecal calprotectin?
Calprotectin is a very stabile fecal maker.
I rather can tell what the current data on fecal calprotectin with regard to esophageal pathologies says.
Dear sir thanks for kind reply...i think Calprotectin is a foecal marker for inflammed colonic mucosa....sometimes it is high with the chronic use of proton pump inhibitors so in GERD it may give false positive results
It is difficult since esophagus has a stratified epithelium. There is only one suggested blood marker namely e-cadherin found significant by Roy C Orlando group (Jovov et al, Role of E-cadherin in the Pathogenesis of Gastroesophageal Reflux Disease. Am J Gastroenterol 2011; 106:1039) however we could not find any significant result in different GERD groups. If there is no blood marker, stool marker is rather difficult. Also remember there are four different GERD subgroups (Erosive, hypersensitive etc)
Dear sir..thanks alot for generous reply...is there a research for e-cadherin or occludins in stool?
It is very difficult to have a reliable marker of mucosal injry in the stools. However, many tests are available to detect this condition in salivary secretion. These test are rapid abd can be easily performed.
I am afraid that protein makes will be denatured in the stomach and other markers will be spitted up by pancreatic enzymes.
Serum Pepsinogen has been proposed as a marker of injury in GORD, but with non satisfactory results (Serum gastrin and pepsinogens do not correlate with the different grades of severity of gastro-oesophageal reflux disease: a matched case-control study. Aliment Pharmacol Ther, 2008). Instead, measurement of pepsinogen in the salivary secretion (Peptest (R)) has yielded better results.
Thanks for your great and effective discussion...i hope to have a common research...we all select a marker and each one of us test it in his locality and collect data to make an effective and grand research
Dear sir...if we have cases presented with chronic cough not responding to conventional therapy...the question is; can w find a marker to differentiate between cough due to GERD or bronchial asthma?
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