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Duodenogastro-oesophageal reflux
1Center for Swallowing and Esophageal Disorder, Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Bailliere'S Best Practice & Research. Clinical Gastroenterology
|September 27, 2000
Summary
Duodenogastro-oesophageal reflux (DGOR) can cause symptoms, but oesophagitis requires simultaneous acid reflux. Therapies should target both acid and DGOR for effective treatment.
Area of Science:
- Gastroenterology
- Oesophageal pathophysiology
Background:
- Duodenogastro-oesophageal reflux (DGOR), previously misnamed 'bile reflux', is investigated for its role in oesophageal mucosal damage.
- Accurate measurement of DGOR was historically challenging, limiting animal-to-human study extrapolation.
Purpose of the Study:
- To elucidate the specific role of DGOR in oesophageal diseases.
- To understand the conditions under which DGOR causes oesophageal symptoms and damage.
Main Methods:
- Utilizing the Bilitec system, an ambulatory bilirubin monitoring device, to enhance the study of DGOR.
- Analyzing clinical data to correlate DGOR presence with oesophageal symptoms and oesophagitis.
Main Results:
- DGOR alone may cause symptoms, but oesophagitis development necessitates concurrent acid reflux.
- The Bilitec system has improved the understanding of DGOR's impact on oesophageal health.
Conclusions:
- Therapeutic strategies should focus on reducing both DGOR and acid reflux.
- Anti-reflux surgery and proton pump inhibitors are effective in decreasing gastric volume and mitigating the damaging potential of both acid and DGOR.