AN AMBULATORY BILE REFLUX MONITORING-SYSTEM - AN IN-VITRO APPRAISAL

Assessment of duodenogastric bile reflux has hitherto been unsatisfact ory. An ambulatory system which utilizes the optical properties of bil irubin is examined. Test readings are correlated with the laboratory v alues for bilirubin in each of a number of physiological solutions. Fo r dilutions of pure bile there was a linear correlation between absorb ance and bilirubin concentration (r = 0.93, p < 0.001). In the more ac idic environment of gastric juice there was also a linear correlation between absorbance and bilirubin concentration (r = 0.65, p < 0.001), but absorbance values were significantly higher than those of pure bil e solutions (F ratio = 130, p < 0.0001). Normal gastric secretions and saliva give low absorbance values (0.02-0.04). Common foodstuffs such as soups, tea and coffee give higher readings and may interfere with bile reflux assessment in a clinical setting. Bilitec 2000 has potenti al for use as an ambulatory bile reflux monitoring system but consider ation should be given to a standard diet or attention must focus on th e fasting period.