Yoshihisa Urita, Toshiyasu Watanabe, Kazuo Hike, Makie Nanami, Tadashi Maeda, Yosuke Sasaki, Asuka Nakayama, Takamasa Ishii, Kaoru Domon, Susumu Ishihara, Masaki Sanaka, Hitoshi Nakajima and Motonobu Sugimoto

From the Department of General Medicine and Emergency Care, Toho University, Tokyo, Japan. Division of Gastroenterology and Hepatology, Toho University, Tokyo, Japan. Department of Hematology, Toho University, Tokyo, Japan.

Abstract

During esophageal acid clearance, salivation plays an important role in defending the esophageal mucosa. Nizatidine, a histamine H2 receptor antagonist, inhibits acetylcholine esterase, with a resultant increase in acetylcholine. We experienced a patient with gastroesophageal reflux disease (GERD) and impaired salivary secretion who has been successfully treated with nizatidine.

Case report: A 63-year-old female visited our hospital with complaints of heartburn and continuous laryngeal discomfort. Saliva scintigraphy was performed to evaluate the salivary function. Washout ratio was decreased to be 25%–40% in individual salivary gland. After the treatment with nizatidine, salivary scintigraphy demonstrated the increased washout ratios. The values of both parotid glands increased up to 90%, whereas those of submandibular glands improved to be around a normal range. GERD symptoms disappeared completely after treatment. In conclusion, nizatidine may be one of therapeutic options for low salivary excretion.

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