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Alkaline reflux gastritis.

W R Burden1, R P Hodges, M Hsu

  • 1Department of Surgery, Louisiana State University Medical Center, New Orleans.

The Surgical Clinics of North America
|February 1, 1991
PubMed
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Alkaline reflux gastritis, a complication of gastrectomy, can be treated by rerouting digestive secretions. A Roux-en-Y gastrojejunostomy is effective but may cause delayed gastric emptying.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology

Background:

  • Alkaline reflux gastritis (ARG) is a known complication following gastrectomy procedures, particularly the Billroth II gastrojejunostomy.
  • The condition arises from the reflux of alkaline duodenal, pancreatic, and biliary secretions into the gastric remnant.
  • The exact mechanism by which alkaline secretions cause gastritis remains debated.

Purpose of the Study:

  • To discuss the management of alkaline reflux gastritis.
  • To highlight the efficacy of surgical intervention in rerouting alkaline secretions.
  • To inform about potential complications associated with surgical treatment.

Main Methods:

  • Review of medical literature concerning alkaline reflux gastritis.
  • Discussion of surgical techniques for managing the condition.

Related Experiment Videos

  • Analysis of complications associated with surgical interventions.

    • Main Results:

    • Rerouting alkaline secretions via a Roux-en-Y gastrojejunostomy is the most effective treatment for ARG.
    • This surgical approach involves creating a longer afferent limb (at least 18 inches/40 cm).
    • Delayed gastric emptying is a potential complication, occurring in at least 40% of patients, alongside symptoms of dumping syndrome.

    Conclusions:

    • Surgical rerouting using Roux-en-Y gastrojejunostomy offers the most effective management for alkaline reflux gastritis.
    • Patients and surgeons must be aware of the risk of delayed gastric emptying and dumping syndrome post-surgery.
    • Supportive therapy is crucial for managing the majority of patients experiencing these complications.