PMID- 18946360
OWN - NLM
STAT- MEDLINE
DCOM- 20081222
LR  - 20131121
IS  - 1473-5687 (Electronic)
IS  - 0954-691X (Linking)
VI  - 20
IP  - 12
DP  - 2008 Dec
TI  - Prevalence of pathological duodenogastric reflux and the relationship between 
      duodenogastric and duodenogastrooesophageal reflux in chronic gastrooesophageal 
      reflux disease.
PG  - 1136-43
LID - 10.1097/MEG.0b013e32830aba6d [doi]
AB  - The role of duodenogastric reflux in gastrooesophageal reflux disease is still 
      controversial. AIMS: (i) To determine the prevalence of pathological 
      duodenogastric reflux (DGR) in gastrooesophageal reflux disease patients and (ii) 
      to define the relationship between DGR and duodenogastrooesophageal reflux. 
      METHODS: We evaluated 92 patients referred for investigation of recurrent reflux 
      symptoms after proton pump inhibitors (PPI) therapy. All the patients filled out 
      symptom questionnaires and underwent endoscopy, oesophageal manometry and 
      combined oesophagogastric pH and bilirubin monitoring. RESULTS: Endoscopy divided 
      the 92 patients into four groups (group I: 25 nonoesophagitis patients, group II: 
      26 patients with grade A-B oesophagitis, group III: 21 patients with grade C-D 
      oesophagitis and group IV: 20 patients with Barrett's oesophagus. Twenty-four of 
      the 92 patients (26%) showed pathological DGR. Abnormal oesophageal bilirubin 
      exposure was observed in 62 of the 92 patients (67.4%). Of the 62 patients with 
      abnormal oesophageal bilimetry, 15 (24.2%) patients simultaneously showed 
      pathological DGR. The gastric bilirubin exposure in patients with abnormal 
      oesophageal, Bilitec tests did not differ from that in patients with normal 
      oesophageal bilimetry (P>0.05). A weak correlation between oesophageal and 
      gastric bilirubin exposure, both expressed as a percentage of time, was found 
      (r=0.28; P<0.01). CONCLUSION: Pathological DGR is present in a little more than a 
      quarter of patients with recurrent reflux and dyspeptic symptoms after PPI 
      therapy. Excessive DGR is not a prerequisite for pathological oesophageal 
      exposure to duodenal contents. Gastric bilirubin monitoring may be useful to 
      choose the best surgical treatment for patients with reflux and dyspeptic 
      symptoms refractory to PPI.
FAU - Brillantino, Antonio
AU  - Brillantino A
AD  - VIII Department of General and Gastrointestinal Surgery, School of Medicine, 
      Second University of Naples, Naples, Italy. Antonio_Brillantino@libero.it
FAU - Monaco, Luigi
AU  - Monaco L
FAU - Schettino, Michele
AU  - Schettino M
FAU - Torelli, Francesco
AU  - Torelli F
FAU - Izzo, Giuseppe
AU  - Izzo G
FAU - Cosenza, Angelo
AU  - Cosenza A
FAU - Marano, Luigi
AU  - Marano L
FAU - Di Martino, Natale
AU  - Di Martino N
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
RN  - 0 (Proton Pump Inhibitors)
RN  - RFM9X3LJ49 (Bilirubin)
SB  - IM
MH  - Bilirubin/metabolism
MH  - Chronic Disease
MH  - Duodenogastric Reflux/*complications
MH  - Endoscopy, Gastrointestinal/methods
MH  - Esophageal pH Monitoring
MH  - Esophagitis, Peptic/etiology
MH  - Gastric Acidity Determination
MH  - Gastroesophageal Reflux/drug therapy/*etiology
MH  - Humans
MH  - Manometry/methods
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Quality of Life
MH  - Recurrence
MH  - Treatment Failure
EDAT- 2008/10/24 09:00
MHDA- 2008/12/23 09:00
CRDT- 2008/10/24 09:00
PHST- 2008/10/24 09:00 [pubmed]
PHST- 2008/12/23 09:00 [medline]
PHST- 2008/10/24 09:00 [entrez]
AID - 10.1097/MEG.0b013e32830aba6d [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2008 Dec;20(12):1136-43. doi: 
      10.1097/MEG.0b013e32830aba6d.