Effect of trypsin inhibitor on reflux oesophagitis after total gastrectomy in rats

Abstract

Objective: To characterise alkaline reflux oesophagitis after total gastrectomy in rats from the standpoints of cell proliferation and apoptosis and from its macroscopic and microscopic findings, and to evaluate the preventive and curative effects of camostat mesilate, a trypsin inhibitor. Design: Open laboratory study. Setting: University hospital, Japan. Animals: 70 male Wistar rats. Interventions: Total gastrectomy with Billroth II anastomosis (n = 30) and with Roux-en-Y anastomosis (n = 30) were used to establish reflux oesophagitis. Camostat mesilate was given for prevention and cure. The remaining 10 animals had a sham operation. Main outcome measures: Trypsin activity of the oesophagus, macroscopic and microscopic findings, bromodeoxyuridine (BrdU) and apoptotic cell labelling indices. Results: Reflux oesophagitis was more common and extensive after Billroth II than Roux-en Y anastomosis. The BrdU labelling index was increased in oesophagitis, while the apoptotic index did not change. Camostat mesilate was effective in both preventing and treating oesophagitis. Conclusion: Trypsin has an important role in the development of reflux oesophagitis after total gastrectomy.