Problems in duodenogastric reflux assessment, using bile acid and lysolecithin measurement

In 187 subjects with widely varying degrees of duodenogastric reflux, intragastric bile acid values were compared with reflux measurement by a biliary marker technique involving intragastric recovery of intravenously injected 14C-bile acids. Furthermore, bile acids were compared to lysolecithin in gastric aspirates. The biliary marker principle, as an indirect method, proved unreliable for assessing endogenous bile reflux. Direct analysis of intragastric duodenal contents, promising more accurate, and, in pathophysiological terms, more meaningful results, cannot rely only on bile acid analysis, since highly divergent lysolecithin values may occur. Thus, any sole acid quantification of reflux by indirect or direct methods will fail to qualify its cytotoxic potential.