A team from Munich, Germany, explored the pathogenesis of the prolonged gastroesophageal reflux (GER) duration induced by white wine.
Some 12 healthy volunteers received 300 ml of white wine or tap water, together with a standardized meal.
Esophageal pH and motility were continuously monitored for 90 min after ingestion.
The motility analysis was separately performed for periods with and without GER.
White wine was found to significantly increase the fraction of time esophageal pH was less than 4, reflux frequency, and reflux duration, compared to water.
During periods without GER, no differences in the motility data were observed between wine and water.
However, during GER, the contraction rate after white wine was significantly lower because of an increase in nontransmitted swallows.
In addition, the time until occurrence of the first contraction after GER was significantly prolonged after white wine.
Primary peristalsis was the main first and clearance contraction type.
Furthermore, the percentage of GER episodes with simultaneous contractions and with failed peristalsis was significantly increased with wine.
| White wine increased simultaneous esophageal contractions and the failed peristalsis rate.
| American Journal of Gastroenterology |
Similarly, the percentage of GER episodes with "rereflux" (a further pH drop, common cavity phenomenon in the motility trace) was significantly increased.
The "corrected" mean reflux duration was still prolonged relative to water, but the difference was no longer significant.
The numbers of peristaltic contractions necessary to raise pH to greater than 4 significantly differed for conventionally defined GER episodes between wine and water drinkers.
However, these were similar when counted only from onset of the latest rereflux event until the pH rose to greater than 4.
Author C. Pehl, of the Academic Teaching Hospital Munich-Bogenhausen, concluded on behalf of the group, "The pathogenesis of white wine-induced GER episodes of long duration is 2-fold.
"First, white wine provokes a disturbed esophageal clearance due to an increase in simultaneous contractions and in failed peristalsis.
"The second mechanism is the occurrence of repeated reflux events into the esophagus when pH is still acidic from a previous reflux episode."