Background/Aims:
@EN Esophageal acid clearance is an important mechanism protective against the development of reflux esophagitis. Acid clearance from the esophagus after gastro-esophageal reflux depends on two important mechanisms: esophageal peristalsis to
return
the
displaced gastric content to the stomach and swallowed saliva to neutralize the residual acid that coasts the esophageal mucosa. The present study aims to investigate acid clearance and determine the contributions of esophageal peristalsis,
salivation,
and gravity.
@ES Methods:
@EN We performed the acid clearance test, ambulatory 24 hour esophageal pH study, esophageal manometry and saliva study in 16 consecutive patients with reflux esophagitis, and then compared them with normal controls.
@ES Results:
@EN The clearance of acid instilled into the esophagus was markedly delayed in patients with reflux esophagitis as compared with controls (p<0.05). There was a trend towards a lower peristaltic amplitude in patients with reflux esophagitis, but
this was
statistically not significant. Of the motor events analyzed, there were simultaneous contractions in 4 patients (25.0%), poor wave progression in 4 patients (25.0%), and non-transmitted contraction in 2 patients (12.5%). In Pntients with reflux
esophagitis, the number of reflux episodes, the mean number of reflux episodes greater than 5 minutes, and the percentage of time when the pH was less than 4 were significantly increased compared with controls (p<0.05). The basal and stimulated
salivary
pH and concentration of bicarbonate in patients with reflux esophagitis did not show a significant difference compared with controls.
@ES Conclusions:
@EN We found a significant impairment of acid clearance in patients with reflux esophagitis, and some alterations in esophageal peristalsis but no change in salivary functions. (Korean J Gastroenterol 1995; 27: 275-282)
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