Saliva

Because saliva neutralizes acid, it might be that a decrease in production of saliva could contribute to acid injury of the esophagus in gastroesophageal reflux disease (GERD). No difference has been shown in the saliva production in people without GERD as compared to those with GERD; however, saliva production normally decreases at night while asleep and also with aging. In the setting of decreased esophageal contractions and night-time GE reflux, this decrease in saliva production may contribute to esophageal injury by inadequately neutralizing the refluxed acid that is not effectively cleared from the esophagus. In addition, in the saliva of patients who have erosive esophagitis (severe inflammation of the esophagus from acid injury) there is a decrease in the normal esophageal protective mucosal factors as compared to people without erosive esophagitis.