Haemolytic activity in gastric and duodenal juice

Gastric juice was aspirated during upper endoscopy in 141 patients. In 48 patients duodenal juice was also aspirated. pH, bilirubin concentration, and haemolytic activity were measured in each sample. Patients with atrophic gastritis and subtotal gastrectomy (Billroth II) showed the highest concentrations of haemolytic activity and bilirubin in their gastric juice. Gastric juice of patients with gastric and duodenal ulcer, with gastric erosions, and with antral gastritis was not statistically different from the control group in which 22 of 32 persons had a positive haemolytic activity. The ratio of bilirubin and haemolytic activity concentration was significantly higher in duodenal than in gastric juice. The reason for this phenomenon remains unknown. It is concluded that for practical purposes bile staining more than haemolytic activity of gastric contents is a quite sensitive, though unspecific, sign of abnormal duodenogastric reflux.