ISSN 2410-7751 (Print)
ISSN 2410-776X (Online)

Biotechnologia Acta Т. 19, No. 2, 2026
P. 25-32 , Bibliography  20, Engl.
UDC:  577.1: [616.34-007.43/616.329]
doi: 

SALIVARY BILE ACIDS AS POTENTIAL NONINVASIVE MOLECULAR INDICATORS OF DUODENOGASTROESOPHAGEAL REFLUX EXPOSURE

A.M.Halinska ^{1, 2}, O.V. Severynovska ²

¹ SI “Institute Of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro, Ukraine
² Oles Honchar Dnipro National University, Dnipro, Ukraine

Achalasia of the cardia and hiatal hernia share overlapping symptoms and require clarification of their underlying pathophysiological mechanisms, including a possible duodenogastroesophageal component of reflux. Saliva is an accessible, noninvasive biological medium that may reflect refluxate components and compensatory clearance responses.

Aim. To compare mixed saliva parameters in a control group, in patients with achalasia, and in patients with hiatal hernia, and to identify the parameters most informative for assessing refluxate exposure and protective response.

Materials and Methods. A comparative study was conducted in three independent groups: controls, achalasia (ICD-10 K22.0), and hiatal hernia (ICD-10 K44). Unstimulated mixed saliva collected in the morning under fasting conditions was analyzed. Salivary portion volume, pH, pepsin, glycoproteins, total calcium, NOx, and bile acids were determined. Between-group differences were assessed using the Kruskal-Wallis test followed by pairwise comparisons with Dunn’s test and Bonferroni correction, or using one-way analysis of variance (ANOVA) with Tukey’s honestly significant difference (HSD) post hoc test.

Results. Two parameters were the most informative. Saliva volume was higher in patients with achalasia and hiatal hernia than in controls, with no difference between the clinical groups, suggesting an enhanced salivary clearance response. The concentration of bile acids in saliva was increased in both clinical groups relative to controls. It did not differ between achalasia and hiatal hernia, consistent with a possible contribution of the duodenal reflux component and indicating exposure to refluxate components. Salivary pH, pepsin, glycoproteins, total calcium, and NOx showed no statistically significant between-group differences, highlighting the specificity of changes in salivary parameters.

Conclusions. Saliva volume and bile acids are promising noninvasive indicators that reflect the combined effects of refluxate exposure and compensatory protective mechanisms in esophageal diseases and may provide a basis for the further development of saliva-based biomarker strategies.

Keywords: biomarkers, noninvasive tests, bile acids, achalasia, hiatal hernia, duodenogastroesophageal reflux, saliva-based biomarkers.

© Palladin Institute of Biochemistry of the National Academy of Sciences of Ukraine, 2026