Skip to main content
PMC home page
Gut logoLink to Gut
. 1974 Nov;15(11):852–857. doi: 10.1136/gut.15.11.852

Oesophageal acid clearing: One factor in the production of reflux oesophagitis

C Stanciu, John R Bennett
PMCID: PMC1413059  PMID: 4455562

Abstract

Oesophageal acid clearing has been measured by counting the number of swallows needed to raise the lower oesophageal pH from 1·5 to 5·0 after instilling 15 ml 0·1 N hydrochloric acid. Normal subjects all had a result less than 12, as did asymptomatic patients with hiatal hernias. Patients with symptomatic gastrooesophageal reflux tended to have abnormal acid clearance, as did those with oesophageal motility disorders. Acid clearance correlated well with the mean duration of spontaneous episodes of acid reflux during 15-hour continuous recordings of lower oesophageal pH.

Abnormal acid clearance was improved by raising the bedhead, by medical treatment for oesophagitis, and by metoclopramide.

We conclude that abnormal acid clearing may result from disturbed oesophageal motility and render patients with these disorders susceptible to reflux oesophagitis. However, it also seems that gastrooesophageal reflux may lead to impaired acid clearance, both by creating abnormal motility and by effects on the oesophageal wall, and thus lead to a `vicious-spiral' oesophagitis. In treating gastrooesophageal reflux, attention must be paid to improving acid clearance.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARLOW D. Problems of achalasia. Br J Surg. 1961 May;48:642–645. doi: 10.1002/bjs.18004821212. [DOI] [PubMed] [Google Scholar]
  2. Booth D. J., Kemmerer W. T., Skinner D. B. Acid clearing from the distal esophagus. Arch Surg. 1968 May;96(5):731–734. doi: 10.1001/archsurg.1968.01330230039006. [DOI] [PubMed] [Google Scholar]
  3. CREAMER B. Oesophageal reflux. Lancet. 1955 Feb 5;268(6858):279–281. doi: 10.1016/s0140-6736(55)90108-2. [DOI] [PubMed] [Google Scholar]
  4. ELLIS F., COLE F. L. REFLUX AFTER CARDIOMYOTOMY. Gut. 1965 Feb;6:80–84. doi: 10.1136/gut.6.1.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. NAGLER R., SPIRO H. M. Heartburn in late pregnancy. Manometric studies of esophageal motor function. J Clin Invest. 1961 Jun;40:954–970. doi: 10.1172/JCI104335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Pattrick F. G. Investigation of gastroesophageal reflux in various positions with a two-lumen pH electrode. Gut. 1970 Aug;11(8):659–667. doi: 10.1136/gut.11.8.659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. SIEGEL C. I., HENDRIX T. R. Esophageal motor abnormalities induced by acid perfusion in patients with heartburn. J Clin Invest. 1963 May;42:686–695. doi: 10.1172/JCI104760. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Spencer J. Prolonged pH recording in the study of gastro-oesophageal reflux. Br J Surg. 1969 Dec;56(12):912–914. doi: 10.1002/bjs.1800561211. [DOI] [PubMed] [Google Scholar]
  9. Stanciu C., Bennett J. R. Metoclopramide in gastrooesophageal reflux. Gut. 1973 Apr;14(4):275–279. doi: 10.1136/gut.14.4.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. TUTTLE S. G., BETTARELLO A., GROSSMAN M. I. Esophageal acid perfusion test and a gastroesophageal reflux test in patients with esophagitis. Gastroenterology. 1960 Jun;38:861–872. [PubMed] [Google Scholar]
  11. Ward A. S., Wright D. H., Collis J. L. The assessment of oesophagitis in hiatus hernia patients. Thorax. 1970 Sep;25(5):568–572. doi: 10.1136/thx.25.5.568. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Woodward D. A. Response of the gullet to gastric reflux in patients with hiatus hernia and oesophagitis. Thorax. 1970 Jul;25(4):459–464. doi: 10.1136/thx.25.4.459. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES