Duodenogastro-oesophageal reflux

The role of duodenogastro-oesophageal reflux (DGOR), once erroneously terme d 'bile reflux', in causing oesophageal mucosal damage has been an area of interest in both animal and human studies. However, due to the lack of appr opriate techniques for accurately measuring DGOR, extrapolation of findings from animal studies to humans was difficult to make. The recent advent of the Bilitec system, an ambulatory bilirubin monitoring device, is increasin g our knowledge of the specific role of DGOR in oesophageal diseases. Studi es suggest that the DGOR without acid reflux may result in symptoms but unl ess acid reflux is present simultaneously, it does not cause oesophagitis. Therefore, our therapies should aim at reducing both DGOR and acid reflux. Studies show that this may be accomplished by anti-reflux surgery or the us e of proton pump inhibitors, which, by reducing gastric volume, decrease th e damaging potential of both acid and DGOR.