Influence of a Gastric Tube on Salivary and Pharyngeal Mucous Secretions in Man

Abstract
The contamination of gastric juice by salivary and pharyngeal mucous secretions is influenced by two factors: the control of swallowing and the quantitative variation in salivary secretions induced by the indwelling gastric tube. In order to study the latter factor, comparisons of salivary output were drawn under three conditions: (1) resting, (2) chewing parafilm, (3) presence of a gastric tube introduced orally. In one group of healthy volunteers, the mixed saliva was collected and measured in a 1-hour sample following the three experimental conditions. The fucose, galactose, hexosamines, sialic acids, uronic acids and sulfate concentrations were estimated in salivary dry solids. A nearly 4-fold increase in volume and dry solids was noticed in the ‘parafilm’ and ‘tube’ samples. In the ‘tube’ sample, carbohydrate constituents were twice as high as in the ‘parafilm’ sample and 5–6 times higher as in the ‘resting’ sample. In a second group of volunteers, the same design was carried out, but the collection was fractionated in six; 10-min samples and determinations were limited to fucose and sulfates. Their output was constant under resting conditions and when chewing parafilm. In the presence of a gastric tube, highest values were obtained in the first two samples which were followed by a sharp decrease. In a third group of volunteers a separate collection of salivary and pharyngeal secretions was attempted. The concentration of carbohydrates per ml secretion was 3–5 times higher in the pharyngeal samples, the highest difference being shown by sulfate and uronic acids. It is concluded that on the course of a gastric secretory test, the indwelling gastric tube induces a considerable increase in the acidic mucosubstances of the pharyngeal and salivary secretion. Thus, usual methods (spitting, aspiration, dental pledgets) used to avoid the swallowing of salivary secretions will not eliminate the major source of contamination of gastric juice.