Systematic review: duodenogastroesophageal (biliary) reflux prevalence, symptoms, oesophageal lesions and treatment

Abstract

Summary Background The prevalence of duodenogastroesophageal reflux (DGER) and its effect on symptoms and oesophageal lesions in gastroesophageal reflux disease (GERD) is unclear. Aims To conduct a systematic review to determine the prevalence of DGER among patients with GERD, the effect of DGER on symptoms and oesophageal lesions, and the treatment of DGER. Methods We searched Pubmed and MEDLINE for full text, English language articles until October 2020 that evaluated DGER prevalence among patients with GERD, the effect of DGER on symptoms and oesophageal lesions, and the treatment of DGER. Results We identified 3891 reports and included 35 which analysed DGER prevalence in GERD, 15 which evaluated its effect in non‐erosive reflux disease (NERD), 17 on erosive oesophagitis, 23 in Barrett's, and 13 which evaluated the treatment of DGER. The prevalence of DGER, when evaluated by Bilitec, among all GERD patients ranged from 10% to 97%, in NERD 10%‐63%, in erosive oesophagitis 22%‐80% and in Barrett's 50%‐100%. There were no differences in the presence or degree of DGER among patients who were asymptomatic or symptomatic on proton pump inhibitors (PPI). The most commonly evaluated treatments for DGER were PPIs and DGER reduced post‐PPI therapy in all studies. Conclusions The prevalence of DGER increased with more advanced oesophageal lesions and did not explain persisting symptoms among patients taking PPI therapy. PPIs appear to be effective in the treatment of DGER. DGER remains an important consideration in patients with GERD and future therapies deserve more study.

Assessment of the risk factors of duodenogastric reflux in relation to different dietary habits in a Chinese population of the Zhangjiakou area

“…The results of this study demonstrate that the daily consumption of dairy products and a preference for fried food are independent risk factors for DGR. Previous studies have confirmed that slight levels of DGR may be physiologically present in the stomach after feeding and fasting (13). Bile is considered a major duodenal component.…”

Diagnostic Principles for Chronic Gastritis Associated with Duodenogastric Reflux

“…According to the data of recent epidemiological studies, there has been a decrease in the proportion of Helicobacter pylori-associated gastritis with an increase in the contribution of other etiological factors. Thus, the prevalence of gastritis associated with bile reflux ranges from 17% to 24%, reaching 62% in a cohort of patients with risk factors for duodenogastric reflux [2,3].…”

Evaluation of hematological parameters in the differentiation of bile reflux gastritis and Helicobacter pylori gastritis in children

“…6 Bile reflux gastritis occurs when the contents of the duodenum, which can disrupt the gastric mucosal barrier with various factors, leak back into the stomach and cause inflammation. 7, 8 The majority of cases involve asymptomatic chronic inflammation. Upper gastrointestinal endoscopy is used to differentiate between bile reflux gastritis and H. pylori gastritis.…”