Esophageal emptying and acid neutralization in patients with symptoms of esophageal reflux

Clearance of refluxed acid from the distal esophagus is due to bolus emptying and salivary neutralization of acid. We compared results of 24-hour pH monitoring with acid clearance tests (ACT) and radioisotope swallows (RIS) in 26 symptomatic patients to determine which of the components of acid clea...

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Bibliographic Details
Published in:Annals of surgery 1985-06, Vol.201 (6), p.728-735
Main Authors: FERGUSON, M. K, RYAN, J. W, LITTLE, A. G, SKINNER, D. B
Format: Article
Language:English
Subjects:
Biological and medical sciences
Esophagogastric Junction - physiopathology
Esophagus
Esophagus - diagnostic imaging
Esophagus - physiopathology
Gastroenterology. Liver. Pancreas. Abdomen
Gastroesophageal Reflux - diagnostic imaging
Gastroesophageal Reflux - physiopathology
Humans
Hydrogen-Ion Concentration
Manometry
Medical sciences
Methods
Other diseases. Semiology
Pressure
Radionuclide Imaging
Technetium Tc 99m Sulfur Colloid
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Summary:Clearance of refluxed acid from the distal esophagus is due to bolus emptying and salivary neutralization of acid. We compared results of 24-hour pH monitoring with acid clearance tests (ACT) and radioisotope swallows (RIS) in 26 symptomatic patients to determine which of the components of acid clearance is better correlated with gastroesophageal acid reflux (GER). Seven of eight patients with GER had delayed esophageal emptying on RIS. Abnormal salivary clearance of acid was present in nine of 18 patients without GER, accounting for a high false-positive rate of ACT. Delayed esophageal bolus emptying, not deficient acid neutralization by saliva, is the predominant component of abnormal acid clearance in patients with GER. RIS is superior to ACT as part of the evaluation of reflux symptoms, and may prove to be a valuable screening test for this condition.
ISSN:0003-4932
1528-1140
DOI:10.1097/00000658-198506000-00009