Esophageal function in chronic alcoholics.

We determined whether there are abnormalities in esophageal motility or acid clearance in chronic alcoholics since alterations in these parameters have been implicated in the pathogenesis of esophagitis after chronic ingestion of ethanol. In addition to esophageal manometry, we also performed acid-clearance studies and examined salivary output, acid-neutralizing capacity, and bicarbonate concentration. We found an increased lower esophageal sphincter pressure which reverted to normal after withdrawal from ethanol. Except for a significantly larger number of tertiary contractions, no other abnormality of esophageal motility was found. Salivary flow, acid-neutralizing capacity, and bicarbonate concentration were not significantly different from that in control subjects. However, in contrast to findings in controls, there was no correlation between salivary bicarbonate concentration and acid-neutralizing capacity in the alcoholics. Our results indicate that chronic ethanol ingestion alters some aspects of esophageal function and salivary composition but that these alterations are unlikely to explain the increased risk of esophagitis in alcoholics.