The stomach contents become hypertonic following a meal. They provide esophageal refluxate that is both acidic and hypertonic.
In this study, physicians from Scotland examined esophageal exposure to hypertonic and acidic solutions in patients with gastroesophageal reflux disease (GERD) and Barrett’s esophagus.
The team measured symptom intensity and character during esophageal instillation of water, hypertonic saline, hydrochloric acid (pH 1 and 2.5), and acidified hypertonic saline (pH 1 and 2.5).
They compared healthy controls and GERD patients, with and without Barrett’s esophagus.
|Frequency of nausea was higher in the Barrett’s group.|
|American Journal of Gastroenterology|
The investigators found that GERD patients with Barrett’s esophagus were less sensitive to acid, and more sensitive to hypertonic saline than GERD patients without Barrett's esophagus.
The team identified and an additive effect when the acid and hypertonic solutions were combined, resulting in similar scores in the 2 patient groups
They found that the frequency of nausea was higher in the Barrett’s group, compared to the other GERD patients, after hypertonic saline, and the acid hypertonic combination.
Dr Jonathan Fletcher's team concluded, "Barrett’s mucosa is associated with reduced symptomatic response to acid, increased response to hypertonic solutions, and a higher incidence of nausea in response to either stimulus".