Solid-bolus passage in patients with pathological oesophageal acid clearing

Area of Science:

• Gastroenterology
• Physiology

Background:

• Prolonged acid clearing in the esophagus is associated with impaired solid bolus transport.
• The role of acidification in this transport deterioration is not fully understood.

Purpose of the Study:

• To evaluate the mean transit time (MTT) of a solid bolus in patients with prolonged acid clearing.
• To investigate the influence of esophageal acidification and intubation on solid bolus transport.

Main Methods:

• A scintigraphic non-invasive technique was employed.
• Solid bolus transit was assessed in 17 patients with prolonged acid clearing.
• The effect of esophageal acidification and catheter intubation on bolus sticking was examined.

Main Results:

• Sticking of the solid bolus in the middle third of the esophagus was a common feature in patients with prolonged acid clearing compared to normals.
• Esophageal intubation significantly reduced bolus sticking compared to pre-intubation conditions (p < 0.01).
• Acidification of the esophagus significantly increased bolus sticking compared to the intubated esophagus without acid (p < 0.01).

Conclusions:

• Deteriorated solid bolus transport in patients with prolonged acid clearing is not dependent on acidification.
• Esophageal intubation improves solid bolus passage, reducing sticking.
• Evaluation of MTT for solid bolus transit is unreliable in the presence of frequent sticking, particularly in intubated patients.