Pyloric incompetence in chronic non-specific lung disease

Of 19 patients with chronic non-specific lung disease, chosen without reference to dyspeptic symptoms, 17 (89%) exhibited duodenogastric reflux of barium indicating pyloric incompetence. In the one patient who proved to have a gastric ulcer the amount of reflux diminished when the ulcer healed. The degree of pyloric incompetence was not found to be related to the severity of arterial blood gas or pH disturbance or to the presence of right heart failure. All patients who exhibited reflux had evidence of obstructive airways disease and most were receiving bronchodilators.We believe that reflux of detergent bile into the stomach may explain the high incidence of dyspepsia and acute gastric ulceration in chronic non-specific lung disease.