FREQUENCY OF GASTROESOPHAGEAL REFLUX IN PATIENTS WITH LIVER-CIRRHOSIS

Twenty-five adult patients with liver cirrhosis, and another 30 patien ts with no liver disease but referred with symptoms suggestive of gast roesophageal reflux disease were selected at random. Twenty-four hour ambulatory intra-esophageal pH measurement and upper gastrointestinal endoscopy were carried out on all patients recruited. Applying the for mer test, 16 (64%) of the patients with liver cirrhosis have gastroeso phageal reflux disease. This figure is comparable with the 70% (21/30) rate recorded in the group of dyspeptic patients clinically thought t o have the disorder. A positive endoscopic diagnosis was much lower at 12% and 23%, respectively. No significant differences were observed a mong liver disease patients when they were subdivided in accordance wi th the etiology of liver cirrhosis and the grade of esophageal varices . We conclude that gastroesophageal reflux disease occurs at a high fr equency (64%) in patients with liver cirrhosis and portal hypertension , irrespective of the etiology of cirrhosis and the grade of esophagea l varices. It is therefore considered to be the main cause of esophagi tis in these patients, and that it might play a role in initiating a v ariceal bleeding episode. The latter hypothesis needs further evaluati on.