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A simple method for the quantification of biliary reflux

J J Nicolai, J Silberbusch, F van Roon

    Scandinavian Journal of Gastroenterology
    |January 1, 1980
    PubMed
    Summary
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    This study quantifies biliary gastric reflux using a novel method. Patients with Billroth II gastrectomies and chronic gastritis showed significantly increased reflux compared to controls.

    Area of Science:

    • Gastroenterology
    • Nuclear Medicine
    • Biliary System Physiology

    Background:

    • Biliary gastric reflux is a condition where bile flows back into the stomach.
    • Quantifying this reflux is crucial for understanding gastrointestinal disorders and post-surgical complications.

    Purpose of the Study:

    • To develop and validate a method for quantifying biliary gastric reflux.
    • To assess the prevalence of biliary gastric reflux in various gastrointestinal conditions.

    Main Methods:

    • Utilized 99mTc-diethyl-IDA (a bile-excreted tracer) and cholecystokinin to induce gallbladder contraction and pyloric closure.
    • Measured tracer reflux into the stomach following these physiological stimuli.
    • Compared reflux percentages in control subjects versus patients with Billroth II gastrectomies, chronic gastritis, gastric ulcers, duodenal ulcers, and hiatal hernias.

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    Main Results:

    • Median reflux in controls was 4.3%, with 93% below 9%.
    • Significantly elevated median reflux was observed in Billroth II gastrectomy patients (46%), chronic gastritis (18.1%), and gastric ulcer patients (11.8%).
    • Bile acid measurements and tracer reflux percentages showed a strong correlation (r=0.87).

    Conclusions:

    • The developed method effectively quantifies biliary gastric reflux.
    • Billroth II gastrectomies, chronic gastritis, and gastric ulcers are associated with increased biliary gastric reflux.
    • Bilirubin measurements may underestimate reflux, while bile acid and tracer methods are reliable.