Chronic xerostomia increases esophageal acid exposure and is associated with esophageal injury
Article Abstract:
The esophagus, the connection between the pharynx and stomach, is sensitive to acids produced in the stomach. The acids can cause an inflammation (esophagitis) when the acids are not cleared promptly. Esophageal acid is cleared by swallowing and saliva, but it can be delayed when saliva production is abnormally low (xerostomia), as can result from radiation therapy to head and neck cancers, or from medications. This study examined the effects chronic xerostomia on esophageal acid clearance and on esophageal abnormalities. Saliva production and esophageal motility (movement) were measured in 16 subjects with chronic xerostomia due to radiation or medication, and in 19 control subjects. Saliva flow averaged 0.58 mL/min at rest and 3.4 mL/min after stimulation in control subjects, while it averaged 0.1 mL/min at rest and 0.8 mL/min after stimulation in the subjects with xerostomia, a significant difference. Tests measuring swallowing found no significant differences between the two groups. Acid clearance was significantly delayed in the subjects with xerostomia. Results from monitoring the acidity of the esophagus for 24 hours revealed significant abnormalities in the xerostomia subjects. Signs of esophagitis were visible with esophagoscopy (inspection of the esophagus with an optical instrument) in 4 of the 16 subjects with xerostomia, but in none of 9 controls examined. Microscopic evidence of inflammation (namely, the presence of white blood cells) was found in 10 of the 16 subjects with xerostomia, but in only 2 of the 9 control subjects. These results confirm that long-tern salivary deficiency, chronic xerostomia, can cause decreased esophageal acid clearance and abnormal acidity levels, which can lead to esophageal injury. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Injectable and bulk-forming agents for enhancing the lower Esophageal Sphincter
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Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 2003
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