Suzuki, H.; Iijima, K.; Henry, E.; McElroy, K.; Scobie, G.; McColl, K.E.L.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA20
Academic Journal
Background: The lumen of the oesophagus has a high nitrite concentration due to the enterosalivary recirculation of dietary nitrate. On entering the acidic stomach, the nitrite is converted to nitric oxide, which may contribute to mutagenesis at the cardia. Aim: To study luminal nitrite chemistry in patients with Barrett's oesophagus. Methods: Using microdialysis probes, we studied nitrite concentration in saliva, proximal oesophagus within the Barrett's segment, and proximal and distal stomach of 10 Barrett's patients before and following nitrate (2 mmol) administration. Results were compared with 17 healthy controls. In a subgroup of Barrett's patients, we simultaneously monitored oesophageal pH and nitric oxide concentration. Results: In the healthy controls, a high nitrite concentration was present in saliva (mean fasting = 37 µM, after nitrate = 203 µM) and throughout the length of the oesophagus (fasting = 29 µM, after nitrite = 181 µM) but fell by 75% on entering the acidic gastric cardia. The fall in nitrite was associated with a high cardia concentration of nitric oxide (fasting = 2.4 µM, after nitrite = 7.5 µM). In the Barrett's patients, similarly high concentrations of nitrite were present in saliva and in the proximal oesophagus but the nitrite concentration fell by 98% on entering the Barrett's segment exposed to acid reflux. Simultaneous recording of pH and nitric oxide concentration within the Barrett's segment indicated that the reflux of acidic gastric juice into the Barrett's segment resulted in the immediate generation of high concentrations of nitric oxide within the oesophageal lumen (fasting = 13 µM, after nitrate = 20 µM). Conclusions: The lumen of the normal oesophagus contains high concentrations of nitrite derived from the enterosalivary recirculation of dietary nitrate. The reflux of acidic gastric juice into the distal oesophagus immediately converts the nitrite to nitric oxide. The...


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