Moazzez, R.; Anggiansah, A.; Bartlett, D.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA37
Academic Journal
Introduction: Heartburn and regurgitation are known to be reliable indicators of gastro-oesophageal reflux (GOR). Saliva has been shown to prevent GOR damage, by diluting and buffering the gastric acid and also by initiating primary peristalsis. Aim: The aim was to assess salivary flow rate and buffering capacity of stimulated saliva in patients complaining of GOR symptoms compared with a group of controls without GOR symptoms. Method: 47 patients (mean age 44) referred with GOR symptoms and 30 age matched controls (mean age 41) were studied. Patients and controls were starved for 4 h. Saliva was stimulated by chewing a piece of paraffin wax. Salivary flow rate was calculated as time taken to collect 3 mi of saliva. The salivary buffering capacity was assessed by mixing 1 ml of saliva with a standard buffer solution to analyse the final pH. All saliva was collected mid-morning. All patients then proceeded to have manometry and ambulatory 24 h pH tests. Results: 57.6% of patients were diagnosed with reflux disease. 65.9% had symptoms associated with reflux and 56% had a symptom index (percentage of symptom associated with reflux) > 50%. The median and range values for salivary buffering capacity were significantly lower for patients than controls (p = 0.0004). There was no significant difference in the salivary flow rate beh,veen patients and controls. Conclusions: Pathological reflux and symptoms associated with GOR were common in this group of patients. The causes of GOR disease and symptoms are multifactorial, however, the poor buffering capacity of saliva may be one of the important factors for the presence of GOR symptoms and disease.


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