Neutralization by Saliva

Even when peristalsis or gravity clears the esophagus of gastric contents, the pH of the esophageal mucosa remains low. Bicarbonate in saliva helps neutralize any remaining hydrogen ions. Chewing increases salivation. This provides more salivary bicarbonate, mucus, and other substances that help protect the esophagus against reflux damage. Salivation is inactive at night, worsening the effects of GERD when one retires. Patient with scleroderma and some other rheumatic disorders have diminished saliva production, further jeopardizing a diseased esophagus. Smokers also produce less saliva, providing yet another reason to quit.