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

Journal Article · Thu Feb 02 00:00:00 EST 1984 · N.Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198402023100503· OSTI ID:6540168

Helm, J F; Dodds, W J; Pelc, L R; Palmer, D W; Hogan, W J; Teeter, B C

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.

• Research Organization: Medical Coll. of Wisconsin, Milwaukee
• OSTI ID: 6540168
• Journal Information: N.Engl. J. Med.; (United States), Vol. 310:5
• Country of Publication: United States
• Language: English

Related Subjects

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