title: Studies of luminal and mucosal pH in reflux esophagitis and antral gastritis.
abstract: Luminal and mucosal pH were measured endoscopically in patients with reflux esophagitis and antral gastritis and in control subjects. In all subjects, significant lumen-to-mucosa gradients were observed in the esophagus, stomach and acidified proximal duodenum. In the reflux patients luminal pH was lower in the fundus (mean +/- SEM, control vs. reflux esophagitis: 2.01 +/- 0.17 vs. 1.32 +/- 0.18; p less than 0.02) and antrum (3.51 +/- 0.35 vs. 2.13 +/- 0.24; p less than 0.01) and, in the gastritis patients, in the fundus (2.01 +/- 0.17 vs. 1.3 +/- 0.17; p less than 0.02). In both patient groups, mucosal pH was lower in the fundus (control vs. reflux vs. gastritis: 4.84 +/- 0.37 vs. 3.37 +/- 0.61 vs. 3.12 +/- 0.6; p less than 0.05) and acidified duodenal cap (6.74 +/- 0.13 vs. 6.09 +/- 0.24 vs. 5.73 +/- 0.46; p less than 0.03). Mucosal pH profiles at the various sites showed less resistance of the gradient to a highly acidic environment in both the lower esophagus and antrum than in fundus and duodenum, and this was the case in the patient and control groups. Though associated with a more acid environment, neither esophagitis nor antral gastritis exhibits a specific deficit in the 'mucus-bicarbonate barrier', suggesting that the pathogenesis of these disorders may depend more on abnormal 'attack' rather than impaired defense.
authors.affiliation: University Department of Medicine, Hope Hospital (University of Manchester Medical School), Salford, UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Quigley
authors.forename: L A
authors.initials: LA
authors.lastname: Turnberg
mesh_terms: D000328:Adult; D004724:Endoscopy; D004942:Esophagitis, Peptic / Q000209:etiology* / Q000503:physiopathology; D004947:Esophagus / Q000502:physiology*; D005260:Female; D005753:Gastric Mucosa / Q000502:physiology; D005756:Gastritis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum; D013270:Stomach / Q000502:physiology*