Chronic xerostomia increases esophageal acid exposure and is associated with esophageal injury

Objective: To assess the effects of chronic xerostomia on parameters of gastroesophageal reflux and esophagitis. Design: Observational study of a cohort of male patients with xerostomia and age-matched control subjects. Setting: Tertiary-care Veterans Affairs Medical Center. Subjects: Sixteen male patients with chronic xerostomia secondary to radiation for head and neck cancers or medications. Nineteen age-matched male control subjects with comparable alcohol and smoking histories. Measurements and main results: Esophageal motility was similar in patients with xerostomia and controls. Clearance of acid from the esophagus and 24-hour intraesophageal pH were markedly abnormal in patients with xerostomia. Symptoms and signs of esophagitis were significantly more frequent in subjects with xerostomia. Conclusions: Chronic xerostomia may predispose to esophageal injury, at least in part, by decreasing the clearance of acid from the esophagus and altering 24-hour intraesophageal pH. Esophageal injury is a previously unreported complication of long-term salivary deficiency.