Heartburn and Mucosal Barrier Weakness

Abstract

Most of the patients who suffer from illness of the digestive tract do not show any signs of lesion after a careful examination. They are classified as “dyspentic” or of “psychosomatic” patients; many cases seem to have a functional disorder somewhere in the digestive tract. Our aim is to show that some patients have a mucosal defect which we shall call “mucosal barrier weakness.” The rationale of this hypothetic mechanism is:

• 1. Experimental cytoaggression by different drugs is clearly established.

• 2. The major symptom of many dyspeptic patients is epigastric heartburn (quite different from pyrosis, which is a retrosternal and ascending pain), which appears shortly after ingestion of some beverages (white wine, coffee) or meals (jam or spices). These nutrients may possibly act as cytoaggressors.

• 3. We have found [2] in normal subjects that montmorrillonnite, an inert and neutral clay, reduces the aggressive effect of aspirin not only when they are both ingested at the same time, but also when aspirin is ingested 24 h after the clay (Tarnasky et al. have observed the same with glucagon [8]).

• 4. According to the general law linking pathological and physiological mechanisms (the first being either an enhancement or a diminution of the second), one may hypothesize that if some substances are able to increase the resistance of the mucosa, some others could produce the opposite: a weakening of the mucosal barrier.