Cervical dysphagia is associated with gastric hyperacidity

Area of Science:

• Gastroenterology
• Digestive Health
• Esophageal Physiology

Background:

• The relationship between upper esophageal symptoms and acid gastroesophageal reflux remains debated.
• Gastroesophageal reflux disease (GERD) affects a significant portion of the population, with varied symptom presentations.

Purpose of the Study:

• To investigate the association between gastric acid hypersecretion and upper esophageal symptoms.
• To determine if gastric acid hypersecretion influences esophageal acid exposure, esophagitis, and dysphagia.

Main Methods:

• Gastric acid analysis, 24-hour esophageal pH monitoring, and esophageal manometry were performed on 150 patients with GERD-suggestive symptoms.
• Patients were categorized into gastric acid hypersecretors (HS) and normosecretors (NS) for comparison.
• Upper esophageal sphincter (UES) manometry assessed pharyngeal and UES pressures and length.

Main Results:

• Gastric acid hypersecretion was identified in 15% of patients.
• Hypersecretors showed significantly higher esophageal acid exposure (score 70 vs. 36.1) and a greater incidence of esophagitis (67% vs. 14%).
• Cervical dysphagia was more prevalent in hypersecretors (8/22) compared to normosecretors (1/25), with no identified anatomical lesions or UES manometry abnormalities.

Conclusions:

• Gastric acid hypersecretion is linked to increased acid reflux, esophagitis, and cervical dysphagia.
• Standard stationary esophageal manometry did not reveal abnormalities in patients with hypersecretion and dysphagia.
• Further investigation with prolonged esophageal monitoring may be necessary to elucidate the mechanisms behind these associations.