Chronic intragastric bile contamination and lower esophageal sphincter competence. An experimental study in dogs

The possible association between intragastric bile reflux and lower esophageal sphincter (LES) incompetence was elucidated in an experimental work in dogs. Chronic intragestric bile contamination was produced by cholecystogastrostomy. The effect of this procedure on LES competence was evaluated by manometric, radiologic and endoscopic studies two weeks, one month, and then once a month for 6 months after operation. No significant change occurred in LES pressure, and neither radiological reflux nor endoscopic evidence of esophagitis developed during the follow-up period. According to the present study intragastric bile reflux does not have a significant role in the pathogenesis of LES incompetence in the dog, but esophagitis effected by bile reflux seems to require previously existing LES incompetence.