Studies on oesophagitis--no evidence for pyloric incompetence as a primary etiological factor. a scintigraphic study...

Duodeno-gastric bile reflux was studied by means of a non-invasive scintigraphic technique in 15 patients with symptomatic oesophagitis. The fate of an intravenously administered, bile-excreted radiopharmaceutic, 99Tcm-Solco-HIDA, was followed with a gamma camera. In 12 patients with an intact pylorus and in one patient operated upon by truncal vagotomy and pyloroplasty no evidence of bile reflux to the stomach was found. One of two patients earlier operated upon by a Billroth I gastrectomy had scintigraphic evidence of a severe bile reflux. We conclude that duodeno-gastric bile reflux is uncommon in patients with hiatal hernia and oesophagitis, and hence that normally pyloric incompetence is of minor importance for the development of this disorder.