Intragastric bile acids and scintigraphy in the assessment of duodenogastric reflux

Houghton, P. W.; Mortensen, N. J. McC.; Thomas, W. E. G.; Cooper, M. J.; Morgan, Anthony; Davies, E. Rhys

doi:10.1002/bjs.1800730415

Cited by 20 publications

(8 citation statements)

References 14 publications

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“…They found a close cor relation between samples taken at endoscopy and by nasao gastric suction [27], Houghton et al [28] have found a significant correlation between intragastric bile acid levels and the degree of duodenogastric reflux assessed by BIDAT99m scintigraphy. These results suggest that a single measure of bile acid in the gastric juice can be used as a good reflection of the duodenogastric reflux in a population.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Bile Reflux in the Elderly

Safe¹,

Nwose²,

Sheehan

et al. 1993

Gerontology

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Duodenogastric bile reflux is common in postoperative stomach but has been reported in intact stomachs. Spontaneous bile reflux in the elderly has not been studied before. This has been assessed in dyspeptic elderly and young patients. Total bile acid (TBA) levels and pH were measured in the samples of fasting gastric juice. Antral biopsies were taken for histological examination including Helicobacter pylori identification. TBA levels were significantly higher in elderly patients with gastritis in comparison to elderly and young normal groups. Only 10% of elderly patients with gastritis and 7% with gastric ulcer has abnormal TBA ( > 1 mmol/l). There was some correlation between the pH and TBA but a significant proportion of elderly patients has pH > 4 with a normal TBA. TBA levels were not significantly different in H. pylori +ve and H. pylori -ve patients. Nineteen elderly patients had evidence of reactive gastritis. Five of these patients had raised TBA levels with severe H. pylori infection. The remaining 15 patients had normal TBA. These patients were on NSAIDs and 4 of them had H. pylori infection. We conclude that spontaneous bile reflux in the elderly is uncommon. Hypochlorhydria which is observed in the elderly is not caused by alkaline bile reflux. The main cause of reactive gastritis in the elderly is NSAIDs ingestion.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Bile Reflux in the Elderly

Safe¹,

Nwose²,

Sheehan

et al. 1993

Gerontology

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show abstract

“…HIDA scintigraphy has been used, but this is a comparatively insensitive and unphysiological method for the measurement of gastrooesophageal reflux. 6 Aspiration studies have also been performed to determine the quantity of bile acids in oesphageal refluxate, but this is cumbersome, invasive, and as with scintigraphy it is unphysiological, measuring short time periods in static conditions. Ambulatory 24 hour pH monitoring has been used, the assumption being that an alkaline shift in pH >7 equates with the presence of duodenal contents.…”

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confidence: 99%

The relationship between acid and bile reflux and symptoms in gastro-oesophageal reflux disease.

Marshall

Anggiansah

Owen

1997

Gut

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Background-The role of bile in the genesis of oesophageal symptoms and disease is incompletely understood. A new method of ambulatory bile monitoring may help to define this role. Ai>ns-To establish the relationship between symptom events and acid and bile reflux episodes. Patients-59 consecutive patients presenting for further investigation of gastrooesophageal reflux disease. Methods-All patients underwent combined ambulatory pH and bile monitoring. For each patient, a symptom index (SI) was calculated in relation to both acid reflux and bile reflux episodes. Results-Patients were divided into those without (group 1, n=21) and those with (group 2, n=38) acid reflux. A total of 394 symptoms were identified in 59 patients. In group 1, there were fewer symptom events per patient (mean 4-1) than group 2 (mean 8-1). Twenty three per cent of symptom events were associated with acid reflux in group 1 and 41% in group 2. Only 6% ofsymptom events in both groups were related to bile reflux. In group 1 both the acid and bile related SI score were low. In group 2 the bile related SI score was low, but the acid related SI score was high. Conclusions-Symptoms are much more often related to acid reflux than bile reflux. Bile reflux does not seem to be a major factor in producing oesophageal symtoms.

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“…The scintigraphic technique used was based on that validated by Houghton et al 6 in a study of 105 patients undergoing gastroscopy, in which there was significant correlation between intragastric bile acid levels and the degree of scintigraphic bile reflux.…”

Section: Methodsmentioning

confidence: 99%

Duodeno-gastric Reflux and Gastric Adenomas: A Scintigraphic Study in Patients with Familial Adenomatous Polyposis

1991

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SummaryTo test whether the presence of gastric adenomas (dysplasia) was associated with gastric reflux of duodenal contents, six patients with familial adenomatous polyposis (FAP) who had gastric adenomas and nine matched FAP patients without gastric adenomas underwent scintigraphic duodeno-gastric reflux scanning. Reflux was graded 0-6, where O=no reflux, l=intermittent reflux into antrum only, 2=prolonged reflux into antrum only, 3=intermittent reflux into body, 4=prolonged reflux into body, 5=intermittent reflux into body and fundus, and 6=prolonged reflux into body and fundus. FAP patients with gastric adenomas had more severe reflux (median 6, range 4-6) than did controls (median 3, range 0-6; P=0.009, Mann-Whitney U test). These results are consistent with a role for bile in the development of gastric adenomatous polyps and suggest that bile is involved in the dysplasiacarcinoma sequence.

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Intragastric bile acids and scintigraphy in the assessment of duodenogastric reflux

Cited by 20 publications

References 14 publications

Spontaneous Bile Reflux in the Elderly

Spontaneous Bile Reflux in the Elderly

The relationship between acid and bile reflux and symptoms in gastro-oesophageal reflux disease.

Duodeno-gastric Reflux and Gastric Adenomas: A Scintigraphic Study in Patients with Familial Adenomatous Polyposis

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