Alkaline intra-oesophageal pH and gastro-oesophageal reflux in patients with peptic oesophagitis.

Simultaneous 22-h measurements of intra-oesophageal and intragastric pH were made in 22 patients with symptoms of gastro-oesophageal reflux (7 with peptic oesophagitis, 8 with peptic oesophageal stricture, and 7 with peptic oesophagitis and previous partial gastrectomy) to determine whether alkaline intra-oesophageal pH is a consequence of alkaline gastro-oesophageal reflux. In the three groups of patients intra-oesophageal pH was greater than 7 for 16.9 +/- 4.8%, 27.5 +/- 7.6%, and 21.0 +/- 7.7%, respectively, of total recording time (p = NS). Intragastric pH greater than 7 was recorded only in the patients with partial gastrectomy (10.3 +/- 5.3% of recording time; p less than 0.01 in comparison with the other groups). Elevations of intra-oesophageal pH to greater than 7 never occurred during episodes of alkalinization of intragastric pH. These results suggest that refluxed fluids are unlikely to be the cause of alkaline intra-oesophageal pH in patients with peptic oesophagitis.