Altered taste perception in patients with gastroesophagealreflux disease

Objective: Patients with gastroesophageal reflux disease (GERD) may experience an altered taste perception, which is likely associated with a direct damage of the taste buds within oral cavity by refluxate. Our aim is to study the taste perception in GERD patients in the absence of ear-nose-throat diseases. Methods: Twenty-four clinically and instrumentally diagnosed GERD patients (18 males and 6 females, age range 25–69 years) and twenty gender and age matched healthy subjects (HS) were studied. All subjects underwent a standardized taste-testing to evaluate the ability of each subject to identify sweet, bitter, salty, umami and sour taste. The following substances served as specific taste agonists: acesulfame K (30 m mol L)1), quinine (10 m mol L)1), NaCl (120 m mol L)1), monopotassium glutamate+ inosine monophosphate, (30+0.5 m mol L)1), and citric acid (50 m mol L)1), respectively. In addition each subject was asked to score the intensity of each taste by using a 100 mm line-visual analogue scale (VAS). Results: The percentage of overall taste misperception was significantly higher in GERD than in HS (23% vs 13, respectively, P = 0.003), with salty representing the most frequent misperceived taste (40% vs 13, P = 0.009). In the subset of GERD, but not in HS, a gender difference in the ability to correctly identify the taste (M 73% vs F 90 P = 0.004) was also found. GERD patients compared to HS, reported a significant higher perception for acid (70 ± 21 vs. 58 ± 22 mm, P = 0.009) and lower perception for salty (53 ± 19 vs. 66 ± 20, P = 0.001) respectively. Conclusion: GERD patients showed a significant degree of taste misperception. The ability of patients to score acidity more than healthy subjects may suggest a possible sensitization of sour taste receptors. Translating this hypothesis in esophagus, a similar effect could be supposed to participate to symptoms generation in GERD patients.