Simultane Langzeitmessung des duodenogastralen Refluxes und der gastroduodenalen Motilität

Thomas, H.; Wilhelm, L.; Petermann, J.; Rosenbaum, K D; Lorenz, D.

doi:10.1007/s001040050241

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…More DGR was demonstrated in healthy individuals at night than during the daytime, which may be associated with an alkaline shift in the pH, in accordance with previously published studies [15, 17, 23]. The precise mechanism by which nocturnal DGR occurs and the role bodily posture may play remain unclear.…”

Section: Discussionsupporting

confidence: 89%

Bile Reflux into the Stomach and the Esophagus for Volunteers Older than 40 Years

Bollschweiler

Wolfgarten²,

Pütz³

et al. 2005

Digestion

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Background: An increased incidence of Barrett’s esophagus in cases with combined acidic and bile reflux is reported. The volunteers serving as controls in those studies were significantly younger than the patients. The aim of this study was to analyze bile reflux patterns of healthy volunteers aged comparably to patients with Barrett’s esophagus. Subjects and Methods: 19 older (8 f, 11 m; median age 51 years) (OV) and 20 younger (10 f, 10 m; median age 25 years) (YV) healthy volunteers without history of gastrointestinal disease or medication underwent simultaneous 24-hour pH and bile monitoring (Bilitec^®). All subjects consumed a special diet that did not interfere with bile measurements. Indicators for bile reflux in the stomach and esophagus: bilirubin probe absorption >0.25 in total measuring period (TM), upright position (excluding postprandial periods) (UP) and supine period (SP). Results: There were no differences between older and younger volunteers in pH monitoring. Comparing the periods of bilirubin exposure of the stomach, the median (lower and upper quartile) percentage of time was OV = 5.7% (1.0–15.0%) and YV = 3.5% (0.1–7.8%) respectively for TM (n.s.), OV = 3.1% (0.7–9.4%) and YV = 0.4% (0.0–7.1%) for UP (n.s.), and OV = 2.1% (0.2–16.7%) and YV = 5.9% (0.0–12.2%) respectively for SP (n.s.). In 10/19 older volunteers and in 18/20 younger volunteers, no reflux of bile into the esophagus was measured. However, 4 older volunteers presented bile reflux from 4.6 to 51% of the total measuring period in contrast to the younger group with a maximum of 1.3% of TM. Conclusion: No significant differences in bile reflux into the stomach were distinguishable between younger and older healthy volunteers, but older volunteers more frequently exhibited bile reflux into the esophagus.

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Section: Discussionsupporting

confidence: 89%

Bile Reflux into the Stomach and the Esophagus for Volunteers Older than 40 Years

Bollschweiler

Wolfgarten²,

Pütz³

et al. 2005

Digestion

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Die sekundäre Ulcusperforation nach endoskopischer Blutstillung durch Fibrinklebung

Wenk¹,

B²,

Bergmann³

et al. 1998

Chirurg

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Emergency treatment of bleeding ulcer of the duodenum is endoscopy and endoscopic blood-staunching. In high-risk patients with Forrest Ia lesions or ulcers with visible vessel (Forrest IIa) endoscopic follow-up or early elective operation is required. Fibrin sealing can improve the results of endoscopic injection therapy for bleeding ulcer. Nevertheless, severe complications such as secondary perforation of the fibrin clot or recurrent bleeding can occur. Identification of high-risk patients and complications requires close monitoring and attention. A case of a secondary perforation of a bleeding ulcer of the duodenum after fibrin sealing is reported.

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Duodeno-Gastric-Esophageal Reflux—What is Pathologic? Comparison of Patients with Barrett’s Esophagus and Age-Matched Volunteers

Wolfgarten

Pütz

Hölscher

et al. 2007

Journal of Gastrointestinal Surgery

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Introduction The aim of the study was to analyse pH-and bile-monitoring data in patients with Barrett's esophagus and in age-and gender-matched controls. Subjects and Methods Twenty-four consecutive Barrett's patients (8 females, 16 males, mean age 57 years), 21 patients with esophagitis (10 females, 11 males, mean age 58 years), and 19 healthy controls (8 females, 11 males, mean age 51 years), were included. Only patients underwent endoscopy with biopsy. All groups were investigated with manometry, gastric and esophageal 24-h pH, and simultaneous bile monitoring according to a standardized protocol. A bilirubin absorption >0.25 was determined as noxious bile reflux. The receiver operator characteristic (ROC) method was applied to determine the optimal cutoff value of pathologic bilirubin levels. Results Of Barrett's patients, 79% had pathologic acidic gastric reflux (pH<4 >5% of total measuring time). However, 32% of healthy controls also had acid reflux (p<0.05) without any symptoms. The median of esophageal bile reflux was 7.8% (lower quartile (LQ)-upper quartile (UQ)=1.6-17.8%) in Barrett's patients, in patients with esophagitis, 3.5% (LQ-UQ= 0.1-13.5), and in contrast to 0% (LQ-UQ=0-1.0%) in controls, p=0.001. ROC analysis showed the optimal dividing value for patients at more than 1% bile reflux over 24 h (75% sensitivity, 84% specificity). Conclusion An optimal threshold to differentiate between normal and pathological bile reflux into the esophagus is 1% (24-h bile monitoring with an absorbance >0.25).

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Simultane Langzeitmessung des duodenogastralen Refluxes und der gastroduodenalen Motilität

Cited by 4 publications

References 14 publications

Bile Reflux into the Stomach and the Esophagus for Volunteers Older than 40 Years

Bile Reflux into the Stomach and the Esophagus for Volunteers Older than 40 Years

Die sekundäre Ulcusperforation nach endoskopischer Blutstillung durch Fibrinklebung

Duodeno-Gastric-Esophageal Reflux—What is Pathologic? Comparison of Patients with Barrett’s Esophagus and Age-Matched Volunteers

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