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Title: Effect of esophageal emptying and saliva on clearance of acid from the esophagus

Abstract

The clearance of acid from the esophagus and esophageal emptying in normal subjects was studied. A 15-ml bolus of 0.1 N hydrochloric acid (pH 1.2) radiolabeled with (/sup 99m/Tc)sulfur colloid was injected into the esophagus, and the subject swallowed every 30 seconds. Concurrent manometry and radionuclide imaging showed nearly complete emptying of acid from the esophagus by an immediate secondary peristaltic sequence, although esophageal pH did not rise until the first swallow 30 seconds later. Esophageal pH then returned to normal by a series of step increases, each associated with a swallow-induced peristaltic sequence. Saliva stimulation by an oral lozenge shortened the time required for acid clearance, whereas aspiration of saliva from the mouth abolished acid clearance. Saliva stimulation or aspiration did not affect the virtually complete emptying of acid volume by the initial peristaltic sequence. It was concluded that esophageal acid clearance normally occurs as a two-step process: (1) Virtually all acid volume is emptied from the esophagus by one or two peristaltic sequences, leaving a minimal residual amount that sustains a low pH, and (2) residual acid is neutralized by swallowed saliva.

Authors:
; ; ; ; ;
Publication Date:
Research Org.:
Medical Coll. of Wisconsin, Milwaukee
OSTI Identifier:
6540168
Resource Type:
Journal Article
Journal Name:
N.Engl. J. Med.; (United States)
Additional Journal Information:
Journal Volume: 310:5
Country of Publication:
United States
Language:
English
Subject:
59 BASIC BIOLOGICAL SCIENCES; ESOPHAGUS; PHYSIOLOGY; RADIOISOTOPE SCANNING; COLLOIDS; HYDROCHLORIC ACID; ISOMERIC NUCLEI; LABELLED COMPOUNDS; MAN; SULFUR; TECHNETIUM 99; TRACER TECHNIQUES; ANIMALS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; COUNTING TECHNIQUES; DIGESTIVE SYSTEM; DISPERSIONS; ELEMENTS; HOURS LIVING RADIOISOTOPES; HYDROGEN COMPOUNDS; INORGANIC ACIDS; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPE APPLICATIONS; ISOTOPES; MAMMALS; NONMETALS; NUCLEI; ODD-EVEN NUCLEI; ORGANS; PRIMATES; RADIOISOTOPES; TECHNETIUM ISOTOPES; VERTEBRATES; YEARS LIVING RADIOISOTOPES; 551001* - Physiological Systems- Tracer Techniques

Citation Formats

Helm, J F, Dodds, W J, Pelc, L R, Palmer, D W, Hogan, W J, and Teeter, B C. Effect of esophageal emptying and saliva on clearance of acid from the esophagus. United States: N. p., 1984. Web. doi:10.1056/NEJM198402023100503.
Helm, J F, Dodds, W J, Pelc, L R, Palmer, D W, Hogan, W J, & Teeter, B C. Effect of esophageal emptying and saliva on clearance of acid from the esophagus. United States. https://doi.org/10.1056/NEJM198402023100503
Helm, J F, Dodds, W J, Pelc, L R, Palmer, D W, Hogan, W J, and Teeter, B C. 1984. "Effect of esophageal emptying and saliva on clearance of acid from the esophagus". United States. https://doi.org/10.1056/NEJM198402023100503.
@article{osti_6540168,
title = {Effect of esophageal emptying and saliva on clearance of acid from the esophagus},
author = {Helm, J F and Dodds, W J and Pelc, L R and Palmer, D W and Hogan, W J and Teeter, B C},
abstractNote = {The clearance of acid from the esophagus and esophageal emptying in normal subjects was studied. A 15-ml bolus of 0.1 N hydrochloric acid (pH 1.2) radiolabeled with (/sup 99m/Tc)sulfur colloid was injected into the esophagus, and the subject swallowed every 30 seconds. Concurrent manometry and radionuclide imaging showed nearly complete emptying of acid from the esophagus by an immediate secondary peristaltic sequence, although esophageal pH did not rise until the first swallow 30 seconds later. Esophageal pH then returned to normal by a series of step increases, each associated with a swallow-induced peristaltic sequence. Saliva stimulation by an oral lozenge shortened the time required for acid clearance, whereas aspiration of saliva from the mouth abolished acid clearance. Saliva stimulation or aspiration did not affect the virtually complete emptying of acid volume by the initial peristaltic sequence. It was concluded that esophageal acid clearance normally occurs as a two-step process: (1) Virtually all acid volume is emptied from the esophagus by one or two peristaltic sequences, leaving a minimal residual amount that sustains a low pH, and (2) residual acid is neutralized by swallowed saliva.},
doi = {10.1056/NEJM198402023100503},
url = {https://www.osti.gov/biblio/6540168}, journal = {N.Engl. J. Med.; (United States)},
number = ,
volume = 310:5,
place = {United States},
year = {Thu Feb 02 00:00:00 EST 1984},
month = {Thu Feb 02 00:00:00 EST 1984}
}