M1845 High Prevalence of Reflux Symptoms in Obese Individuals

Abstract

Background and Aims: Impaired salivary secretion has been reported to cause abnormal acid clearance from the esophagus in gastroesophageal reflux disease (GERD). However, few studies have explained the differences between nonerosive reflux disease (NERD) and erosive esophagitis (EE) with respect to salivary secretion. We have already reported that a noninvasive salivary functional test, modified glucose clearance test, which enabled the distinction between NERD and EE (Aliment Pharmacol & Ther 2008). According to our report, glucose clearance of EE was significantly lower than that of NERD. Saliva has important functions not only to clear gastric acid but also to regenerate esophageal mucosa by epidermal growth factor (EGF). The purpose of this study was to examine the relation between pathophysiology of GERD and the amount of salivary EGF (sEGF) produced. Subjects and Methods: Twenty patients with heartburn (10 NERD and 10 EE) and 10 healthy volunteers were enrolled in this study after an informed consent was obtained from them. Salivary volume was measured by gum test, and the sEGF concentration in the saliva produced by these patients was determined using a commercially available ELISA kit (Quantikine®, R&D systems). To elucidate the differences among the NERD and EE and control groups, salivary volume (mL/ min), sEGF concentration (pg/mL), and sEGF production (pg/min) were measured. sEGF production was calculated as salivary volume multiplied by sEGF concentration. Results: Salivary volume and sEGF concentration were not statistically different among the study groups. However the sEGF production was significantly lower in the EE group than in the NERD and control groups (Table 1). Conclusions: These results suggest that a decrease in sEGF production may be a cause of erosive esophagitis. Table 1: sEGF in the NERD and EE groups