Role of microbial dysbiosis in the pathogenesis of esophageal mucosal disease: A paradigm shift from acid to bacteria?

Table 1 Changes in local flora that occur with particular esophageal disease states

Disease states	Changes in microbiome
GERD	Non-erosive reflux disease: A shift towards Proteobacteria (Neisseria oralis, Moraxella spp.) and Bacteroidetes (Bacteroides uniformis, Capnocytophaga spp., and Prevotella pallens); A shift away from Fusobacteria (Leptotrichia) and Actinobacteria (Rothia spp.); Increased abundance of Dorea spp.
	Reflux esophagitis: Decreased Firmicutes (Mogibacterium spp., Streptococcus infantis, Solobacterium moorei) and increased Fusobacteria (Leptotrichia spp.) and Proteobacteria (Marivita spp., Nisaea spp., Mesorhizobium spp.)
Barrett’s esophagus	Increased Fusobacteria, and Proteobacteria (Neisseria spp., and Campylobacter spp.); Decreased alpha diversity as well as Bacteroidetes and Prevotella
Esophageal adenocarcinoma	Increased abundance of Proteobacteria and decreased Firmicutes; Relatively unchanged Streptococci abundance
Eosinophilic esophagitis	Increased Proteobacteria (Neisseria and Haemophilus) and Corynebacterium; Decrease in Clostridia spp.

GERD: Gastroesophageal reflux disease.