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Related Concept Videos

Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology01:29

Gastroesophageal Reflux Disease I: Meaning and Pathophysiology

Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
Cholecystitis01:20

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
Gastritis II: Pathophysiology01:26

Gastritis II: Pathophysiology

The pathophysiology of gastritis begins with the colonization of the stomach lining by Helicobacter pylori (H. pylori). This bacterium spreads mainly via the oral-oral route through saliva or shared utensils, and can also be transmitted in overcrowded or unhygienic environments through contaminated water, despite its brief survival outside the body.ColonizationOnce ingested, H. pylori enters the stomach and begins colonization by navigating through the mucus layer lining the stomach wall. It...
Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...

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Related Experiment Video

Updated: Jun 30, 2026

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
03:05

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia

Published on: February 16, 2024

Bile Reflux is a Risk Factor for Metachronous Development in Patients with Early Gastric Cancer.

Hiroki Murai1, Takuya Yamada1, Yukihiro Kusumoto1

  • 1Department of Gastroenterology and HepatologyOsaka Rosai HospitalSakaiJapan.

Endoscopy International Open
|June 29, 2026
PubMed
Summary

Bile reflux is a significant risk factor for metachronous development (MD) after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Patients with bile reflux need closer endoscopic surveillance every six months for early detection of new lesions.

Keywords:
diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE)endoscopic resection (ESD, EMRc, …)endoscopy upper GI tractprecancerous conditions & cancerous lesions (displasia and cancer) stomach

More Related Videos

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
07:36

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Published on: February 10, 2023

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Last Updated: Jun 30, 2026

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
03:05

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia

Published on: February 16, 2024

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
07:36

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Published on: February 10, 2023

Area of Science:

  • Gastroenterology
  • Oncology
  • Endoscopic Surgery

Background:

  • Eradicating Helicobacter pylori lowers gastric cancer risk.
  • Metachronous development (MD) occurs in 1-4% annually after endoscopic resection for early gastric cancer (EGC).
  • Limited attention has been given to bile reflux as a risk factor for MD post-endoscopic submucosal dissection (ESD).

Purpose of the Study:

  • To evaluate risk factors for MD after ESD for EGC.
  • To investigate the specific role of bile reflux in MD development.
  • To identify patient subgroups requiring intensified surveillance.

Main Methods:

  • Retrospective analysis of 454 patients undergoing ESD for EGC (2010-2018).
  • MD defined as new lesions >12 months post-ESD.
  • Bile reflux assessed via second-look endoscopy the day after ESD.

Main Results:

  • MD observed in 9.9% of patients over a median follow-up of 34.3 months.
  • Independent risk factors for MD included older age, severe gastric atrophy, xanthoma, and bile reflux.
  • The 5-year MD rate was significantly higher in the bile reflux group (24.2% vs. 11.2%).
  • MD in the bile reflux group was more frequent in the gastric antrum/lower body.
  • Diabetes mellitus was an independent risk factor for bile reflux.

Conclusions:

  • Bile reflux is a significant, independent risk factor for MD after ESD for EGC.
  • This risk is particularly pronounced in gravity-dependent gastric areas.
  • Patients with bile reflux are a high-risk subgroup needing intensive endoscopic surveillance (e.g., every 6 months).