Generation of Gastroesophageal Reflux Disease Symptoms During Esophageal Acid Infusion With Concomitant Esophageal pH Monitoring in Healthy Adults

Abstract

Background/AimsThe sensitivity of the upper and lower esophageal mucosa to acid is considered to differ. We investigated the relationship between pH changes in different sites of the esophagus and generation of gastroesophageal reflux symptoms during an acid infusion test.MethodsAn acid infusion catheter was placed at 5 or 15 cm above the lower esophageal sphincter (LES) in 18 healthy volunteers, while a 2-channel pH sensor catheter was also placed in each with the sensors set at 5 and 15 cm above the LES. Solutions containing water and hydrochloric acid at different concentrations were infused through the infusion catheter.ResultsAcid infusion in the upper esophagus caused a pH drop in both upper and lower esophageal sites, whereas that in the lower esophagus resulted in a significant pH drop only in the lower without a corresponding pH decline in the upper esophagus. Stronger heartburn, chest pain, and chest oppression symptoms were noted when acid was infused in the upper as compared to the lower esophagus, while increased intra-esophageal acidity strengthened each symptom. Regurgitations caused by upper and lower esophageal acid infusions were similar, and not worsened by a larger drop in intra-esophageal pH. Chest pain was caused only by lowered intra-esophageal pH, while heartburn, chest oppression, and regurgitation were induced by a less acidic solution.ConclusionsHigher intra-esophageal acidity caused stronger heartburn, chest pain, and chest oppression symptoms. However, regurgitation was not significantly influenced by intra-esophageal acidity. The upper esophagus showed higher acid sensitivity than the lower esophagus.

Unraveling the Dynamics of Esophageal Motility, Esophagitis Severity, and Age in GERD Patients: A Cross-Sectional Exploration

“…Understanding the implications of decreased contraction amplitude in the distal esophagus for disease progression is crucial, particularly for patients with more severe conditions. Patients with decreased amplitude indicative of ineffective esophageal motility (<30 mm Hg) experience prolonged exposure of the esophagus to pH levels below four and difficulty in esophageal acid clearance compared to patients with normal motility [ 7 , 8 ]. Another study demonstrated that a significant loss of esophageal contractions leads to increased exposure of the distal esophagus to acidic volume when in the supine position, with normal clearance in the upright position [ 9 ].…”

“…Pressure transducers connected to a PC Polygraph HR device recorded manometric signals. Technical details of the procedure have been described elsewhere [ 7 , 8 ].…”

“…At the end of the 24h period, the patients returned to the laboratory for removal of the catheter and analysis of the data recorded. Technical details of the procedure have been described elsewhere [ 7 , 8 ].…”

Surface degradation and biofilm formation on hybrid and nanohybrid composites after immersion in different liquids

“…The effects of such beverages on surface deterioration and degradation of restorative materials and hard tooth tissue are associated with frequency of consumption, temperature, chemical composition, pH, and exposure time [3]. Corrosion is caused by a high content of citric acid, maleic acid, and phosphoric acid [4], and hydrochloric acid from gastroesophageal reflux and eating disorders decreases the pH of the oral environment [5].…”

“…Fig 5. Representative atomic force microscopic images of surface topography of RBC discs after storage for 30 days.…”