Effect of dietary sodium chloride on gastro-oesophageal reflux: A randomized controlled trial

Abstract

Objective.It has been suggested that a high consumption of sodium chloride (NaCl) is associated with reflux symptoms. The objective of this study was to investigate the effect of increased dietary NaCl intake on gastro-oesophageal reflux and reflux mechanisms. Material and methods. In this double-blind, placebo-controlled, crossover study 10 healthy male subjects received 5 g NaCl or placebo in capsules per day for one week, after which concurrent manometric, pH and impedance monitoring was carried out for 4.5 h. Results. Oesophageal acid exposure time (pH < 4) was similar for placebo (median 11% (25th 3–75th 36)) and NaCl (9% (1–36)). No differences in the numbers of reflux episodes were found for NaCl (16 (13.5–22)) and placebo (23 (14.8–27)). Furthermore, similar numbers of liquid acid reflux episodes (placebo 12 (6.5–17.3); NaCl 10 (2.3–14.3)), liquid weakly acidic reflux episodes (placebo 5.5 (4–12.3); NaCl 6.5 (3–10.8)) and gaseous reflux episodes (placebo 1 (0–1.8); NaCl 2 (0–3)) were seen. In both conditions transient lower oesophageal sphincter relaxations (TLOSRs) were the most common reflux mechanism, followed by swallow-induced reflux. High salt intake lowered LOS pressure overall and in the first postprandial hour (p<0.01). Conclusions. High dietary sodium intake does not increase gastro-oesophageal reflux in healthy volunteers, despite a decrease in LOS pressure.