Can the role of esophageal clearance disorders be defined

The multifactorial nature of esophageal reflux disease has become generally accepted by both surgical and gastroenterological physicians. Esophagitis can result from uncontrolled gastroesophageal reflux or impaired acid clearance or a combination of both [1, 2]. In general, the process of lower esophageal acid clearance entails two separate and distinct steps. The first consists of an initial peristaltic wave which virtually empties the acid from the lower esophagus leaving only a residual film which maintains a low pH [3, 4]. In the second step of esophageal clearance, the residual acid film is neutralized by swallowed saliva. Thus, the general process of acid clearance may be prolonged by either abnormal esophageal emptying or impaired salivation.