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

To assess the effects of chronic xerostomia on parameters of gastroesophageal reflux and esophagitis. Observational study of a cohort of male patients with xerostomia and age-matched control subjects. Tertiary-care Veterans Affairs Medical Center. 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. 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. 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.