This is a randomized, open-label pilot study to assess whether treatment with chlorhexidine
mouthwash can alter the esophageal and gastric cardia microbiome
Patients scheduled for upper endoscopy for clinical indications will be randomized to 3 weeks
of either no treatment or use of twice daily chlorhexidine mouthwash leading up to the
endoscopy. There will be 2-3 study visits, at Day 0 and Day 21, and for those subjects in the
mouthwash arm, a final visit 1-2 weeks following the Day 21 visit. Subjects will be required
to fast overnight prior to the visits on Days 0 and 21.
- Age >18
- Scheduled for upper endoscopy for clinical indications
- No allergy or other contraindication to chlorhexidine
- Use of proton pump inhibitors or H2 receptor antagonists within 1 month of enrollment.
Acid suppressant medications raise the gastric pH and can dramatically alter the
gastric and esophageal microbiome.
- History of upper gastrointestinal cancer
- History of histologically proven Barrett's esophagus
- History of antireflux or bariatric surgery, or other gastric or esophageal surgery
- Use of antimicrobial mouthwash within 1 month of enrollment
- Use of antibiotics or immunosuppressant medications within 3 months of enrollment
- Use of steroid inhalers or nasal sprays within 1 month of enrollment
- HIV or other immunosuppressed states or conditions (e.g. active malignancy)
- Pregnant or breast feeding
- Inability to give informed consent