Gadelha KKL, Santos AA, Correia-de-Sá P, Magalhães PJC, da Silva MTB. Can bile salts affect the contractile oesophageal activity associated with gastroesophageal reflux disease? World J Gastroenterol 2026; 32(4): 114560 [DOI: 10.3748/wjg.v32.i4.114560]
Corresponding Author of This Article
Moisés Tolentino Bento da Silva, PhD, Assistant Professor, Laboratory of Physiology, Department of Immuno-Physiology and Pharmacology, School of Medicine and Biomedical Science, Center for Drug Discovery and Innovative Medicines/RISE-Health: Health Research Network, University of Porto, No. 228 Jorge Viterbo Ferreira Street, Porto 4050-313, Portugal. mtsilva@icbas.up.pt
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 28, 2026; 32(4): 114560 Published online Jan 28, 2026. doi: 10.3748/wjg.v32.i4.114560
Can bile salts affect the contractile oesophageal activity associated with gastroesophageal reflux disease?
Kalinne Kelly Lima Gadelha, Armênio Aguiar Santos, Paulo Correia-de-Sá, Pedro Jorge Caldas Magalhães, Moisés Tolentino Bento da Silva
Kalinne Kelly Lima Gadelha, Armênio Aguiar Santos, Pedro Jorge Caldas Magalhães, Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza 60020-181, Ceará, Brazil
Paulo Correia-de-Sá, Laboratory of Pharmacology and Neurobiology, Department of Immuno-Physiology and Pharmacology, School of Medicine and Biomedical Science, Center for Drug Discovery and Innovative Medicines/RISE-Health: Health Research Network, University of Porto, Porto 4050-313, Portugal
Moisés Tolentino Bento da Silva, Laboratory of Physiology, Department of Immuno-Physiology and Pharmacology, School of Medicine and Biomedical Science, Center for Drug Discovery and Innovative Medicines/RISE-Health: Health Research Network, University of Porto, Porto 4050-313, Portugal
Co-corresponding authors: Pedro Jorge Caldas Magalhães and Moisés Tolentino Bento da Silva.
Author contributions: Gadelha KKL, Santos AA, Correia-de-Sá P, Magalhães PJC, and da Silva MTB performed the methodology and wrote, reviewed, and edited the manuscript; Magalhães PJC and da Silva MTB contributed equally as co-corresponding authors. All authors approved the final version to publish.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Moisés Tolentino Bento da Silva, PhD, Assistant Professor, Laboratory of Physiology, Department of Immuno-Physiology and Pharmacology, School of Medicine and Biomedical Science, Center for Drug Discovery and Innovative Medicines/RISE-Health: Health Research Network, University of Porto, No. 228 Jorge Viterbo Ferreira Street, Porto 4050-313, Portugal. mtsilva@icbas.up.pt
Received: September 23, 2025 Revised: November 4, 2025 Accepted: December 3, 2025 Published online: January 28, 2026 Processing time: 121 Days and 19.3 Hours
Abstract
Bile salts are essential molecules that have evolved beyond their digestive surfactant properties to act as relevant pathophysiological signalling modulators. In the gastroesophageal reflux disease (GERD), recurrent exposure of the oesophagus to harmful agents of gastric and duodenal origin, including bile salts, results in chronic inflammation and damage to the oesophageal mucosa, ultimately promoting the progression of the normal oesophageal epithelium to pre-malignant or malignant lesions, such as Barrett’s oesophagus and adenocarcinoma. Although the acidity of the refluxed material has long been considered the leading cause of pathological features in GERD, some patients do not respond adequately to conventional therapy with proton pump inhibitors, implicating non-acidic components of the gastroesophageal reflux originating in the stomach and/or duodenum. Oesophageal motor activity is an essential protection against GERD symptoms, as it directly determines the contact time of the refluxed material inside the oesophagus. Oesophageal dysmotility profiles are documented in GERD, and bile salts appear to contribute to this dysfunction. In this work, we highlight the involvement of bile salts in the pathogenesis of GERD, particularly their effect on oesophageal motility and their potential signalling pathways.
Core Tip: Gastroesophageal reflux disease is characterised by the retrograde flow of gastroduodenal contents into the oesophagus. Although its pathophysiology is not fully understood, it is recognised to evolve into different forms of varying severity, including Barrett’s oesophagus and oesophageal adenocarcinoma. Impaired oesophageal motility, often characterised as hypomotility, is a primary factor contributing to the disease’s development. Studies suggest that the liver-synthesized bile salts, which are duodenal components found in the reflux material, may be directly involved in this dysfunction. Therefore, more in-depth investigations are needed to fully understand gastroesophageal reflux disease’s pathophysiology and the influence of bile salts on oesophageal dysmotility, as well as potential signalling pathways.
