Acidic and Neutral Liquid Ingestion in Patients With Gastroesophageal Reflux Disease

Abstract

-Context -Sour acidic liquid has a slower distal esophageal transit than a neutral liquid. Our hypothesis was that an acidic sour bolus has a different ingestion dynamic than a neutral bolus. Method -In 50 healthy volunteers and 29 patients with gastroesophageal reflux disease (GERD), we evaluated the ingestion dynamics of 100 mL of acidic sour liquid (concentrated lemon juice, pH: 3.0) and 100 mL of water (pH: 6.8). The time to ingest the total volume, the number of swallows to ingest the volume, the interval between swallows, the flux of ingestion and the volume ingested in each swallow was measured. Results -In both groups, healthy volunteers and patients in treatment for GERD, the acidic liquid took longer to be ingested, a higher number of swallows, a slower flux of ingestion and a smaller volume in each swallow than the neutral bolus. There was no difference between healthy volunteers and patients with GERD. The ingestion in women was longer than in men for acidic and neutral liquids. ConclusionAcidic liquid has a different dynamic of ingestion than the neutral liquid, which may be consequence of the slower transit through the distal esophageal body or an anticipation to drink a sour bolus. Patients with GERD have the same prolonged ingestion of the acidic liquid bolus as seen in healthy volunteers.

The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review

“…Acidic foods such as those containing citrus or tomatoes have been noted to have different ingestion dynamic than that of pH-neutral fluids, which may exacerbate GERD symptoms. 17 Ingestion of fatty meals, soft drinks, and chocolate have been suggested to reduce the pressure of the lower esophageal sphincter, increase esophageal acid exposure times, and increase gastric acid production in some studies. Furthermore, saturated fat and cholesterol consumption have been noted to have a dose-response link with GERD symptoms.…”

The Spectrum of Treatment Modalities for Gastroesophageal Reflux Disease (GERD): A Narrative Review

“…The relationship between diet and GERD has been studied in order to provide patients with a more practical approach [ 21 ]. Consumption of certain beverages should be avoided for managing GERD, like acidic beverages, which are known to worsen GERD and precipitate its symptoms [ 22 ]. Carbonated drinks also alter intrabdominal pressure and increase transient lower esophageal sphincter relaxation frequency [ 23 ].…”

The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn

“…recommended for GERD management, however most of these recommendations are based on limited data. For instance, acidic beverages are often hypothesized to worsen GERD and it has been shown that physiologically acidic fluids drop the pH of refluxed stomach contents and increase esophageal clearance time (17). In practice, correlation of symptoms is less clear.…”