Variability in the composition of physiologic duodenogastric reflux

Citation
Kh. Fuchs et al., Variability in the composition of physiologic duodenogastric reflux, J GASTRO S, 3(4), 1999, pp. 389-395
Citations number
43
Categorie Soggetti
Surgery
Journal title
JOURNAL OF GASTROINTESTINAL SURGERY
ISSN journal
1091255X → ACNP
Volume
3
Issue
4
Year of publication
1999
Pages
389 - 395
Database
ISI
SICI code
1091-255X(199907/08)3:4<389:VITCOP>2.0.ZU;2-I
Abstract
Duodenogastric reflux has long been associated with various diseases of the foregut. Even though bile is often used as a marker, duodenogastric reflux consists of other components such as pancreatic juice and duodenal secreti ons. The aim of this study was to investigate the occurrence of duodenogast ric reflux, its components, and the variability of its composition in norma l subjects. Twenty healthy volunteers (7 men and 13 women) whose median age was 24 years underwent combined 24-hour bilirubin and gastric pH monitorin g and intraluminal gastric aspiration. All probes were placed at 5 cm below the lower border of the lower esophageal sphincter. Aspiration was perform ed hourly and at any time when bilirubin and/or pH monitoring showed signs of duodenogastric reflux. Elastase and amylase were measured in the aspirat e. All volunteers had episodes of physiologic duodenogastric reflux. A tota l of 70 episodes of duodenogastric reflux were registered with a median of three episodes (range 1 to 8) per subject. Most bile reflux occurred separa tely from pancreatic enzyme reflux. Pancreatic enzyme aspirate was signific antly more often associated with a rise in pH in comparison to bile reflux (P <0.01). Duodenogastric reflux is a physiologic event with varying compos ition. Both bile and pancreatic enzyme reflux frequently occur separately. These findings could explain the disagreement regarding assessment and inte rpretation of duodenogastric reflux in the past. Thus monitoring of duodeno gastric reflux requires more than the detection of just one component.