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Cervical dysphagia is associated with gastric hyperacidity

S Singh¹, R A Hinder, R Naspetti

¹Creighton University School of Medicine, Department of Surgery, Omaha, Nebraska.

Journal of Clinical Gastroenterology

|March 1, 1993

Summary

Patients with gastric acid hypersecretion experience increased acid reflux, esophagitis, and cervical dysphagia. These symptoms are not linked to abnormalities found in standard esophageal manometry tests.

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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.

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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.