AMBULATORY ESOPHAGEAL BILE REFLUX MONITORING IN BARRETTS-ESOPHAGUS

Bile reflux has been implicated in the pathogenesis of Barrett's oesop hagus but evaluation remains difficult. Bilitec 2000 is an ambulatory system that detects bilirubin based on its spectrophotometric properti es. Oesophageal bile exposure was evaluated in three groups of patient s. Group 1 (n = 11) were normal controls, group 2 (n = 13) were patien ts with uncomplicated gastro-oesophageal reflux and group 3 (n = 12) w ere patients with Barrett's oesophagus. Bile reflux was greater in pat ients with Barrett's mucosa than in controls or those with uncomplicat ed reflux. This difference was seen in the supine and interdigestive p eriods. The percentage of time at which gastric pH was greater than 4 and oesphageal pH was above 7 did not differ between the groups. Bilit ec 2000 detects greater bile reflux in patients with Barrett's oesopha gus. No corresponding gastric or oesophageal alkaline shift is found. This ambulatory bile reflux monitoring system may be a useful tool in clinical practice.