ambulatory oesophageal Bile Reflux monitoring in barrett s oesophagus

Bile Reflux has been implicated in the pathogenesis of Barrett’s oesophagus but evaluation remains difficult. Bilitec 2000 is an ambulatory system that detects bilirubin based on its spectrophotometric properties. Oesophageal Bile exposure was evaluated in three groups of patients. Group 1 (n = 11) were normal controls, group 2 (n = 13) were patients with uncomplicated gastro-oesophageal Reflux and group 3 (n = 12) were patients with Barrett’s oesophagus. Bile Reflux was greater in patients with Barrett’s mucosa than in controls or those with uncomplicated Reflux. This difference was seen in the supine and interdigestive periods. The percentage of time at which gastric pH was greater than 4 and oesophageal pH was above 7 did not differ between the groups. Bilitec 2000 detects greater Bile Reflux in patients with Barrett’s oesophagus. No corresponding gastric or oesophageal alkaline shift is found. This ambulatory Bile Reflux monitoring system may be a useful tool in clinical practice.

an ambulatory Bile Reflux monitoring system an in vitro appraisal

Assessment of duodenogastric Bile Reflux has hitherto been unsatisfactory. An ambulatory system which utilizes the optical properties of bilirubin is examined. Test readings are correlated with the laboratory values for bilirubin in each of a number of physiological solutions. For dilutions of pure Bile there was a linear correlation between absorbance and bilirubin concentration (r=0.93, p<0.001). In the more acidic environment of gastric juice there was also a linear correlation between absorbance and bilirubin concentration (r=0.65, p<0.001), but absorbance values were significantly higher than those of pure Bile solutions (F ratio=130, p<0.0001). Normal gastric secretions and saliva give low absorbance values (0.02-0.04). Common foodstuffs such as soups, tea and coffee give higher readings and may interfere with Bile Reflux assessment in a clinical setting. Bilitec 2000 has potential for use as an ambulatory Bile Reflux monitoring system but consideration should be given to a standard diet or attention must focus on the fasting period.

An ambulatory Bile Reflux monitoring system: an in vitro appraisal

Assessment of duodenogastric Bile Reflux has hitherto been unsatisfactory. An ambulatory system which utilizes the optical properties of bilirubin is examined. Test readings are correlated with the laboratory values for bilirubin in each of a number of physiological solutions. For dilutions of pure Bile there was a linear correlation between absorbance and bilirubin concentration (r=0.93, p

rabeprazole combined with hydrotalcite is effective for patients with Bile Reflux gastritis after cholecystectomy

BACKGROUND: Regardless of surgical technique, patients who have undergone cholecystectomy appear to be predisposed to the development of Bile Reflux gastritis.

role of Bile Reflux and helicobacter pylori infection on inflammation of gastric remnant after distal gastrectomy

OBJECTIVE:  The influence of the main pathogenic factors on remnant gastritis is still to be evaluated. The aim of this study was to investigate the role of Bile Reflux and Helicobacter pylori infection on endoscopic inflammation and histological changes of gastric remnant after distal gastrectomy.

METHODS:  A total of 281 patients with a more than 1-year history of distal gastrectomy were retrospectively involved after excluding those with tumors and ulcers on endoscopy. The severity of endoscopic remnant gastritis and Bile Reflux were recorded during the endoscopy. The histological changes including chronic inflammation, activity, atrophy, intestinal metaplasia and H. pylori were evaluated independently.

RESULTS:  An endoscopic inflammation of remnant gastric mucosae was found in 81.1% (228/281) of the patients. The prevalence of H. pylori infection and Bile Reflux in patients with endoscopic remnant gastritis was more common than in those without gastritis (21.5%vs 0%, 88.6%vs 24.5%, P < 0.0001). The score of histological chronic inflammation was significantly higher in patients with Bile Reflux than in those without obvious Bile Reflux (1.65 vs 1.45, P = 0.02). Chronic inflammation (1.82 vs 1.57), activity (0.78 vs 0.34), atrophy (0.67 vs 0.41) and intestinal metaplasia (0.67 vs 0.27) in H. pylori-positive patients were all significantly more severe than in H. pylori-negative patients.

CONCLUSION:  Bile Reflux and H. pylori infection exacerbates the severity of endoscopic remnant gastritis and chronic histological inflammation.

effects of Bile Reflux on gastric mucosal lesions in patients with dyspepsia or chronic gastritis

AIM: To investigate the influences of Bile Reflux on profiles of gastric mucosal lesions in patients with dyspepsia or chronic gastritis.

METHODS: A total of 49 patients diagnosed with dyspepsia and chronic gastritis underwent 24-h ambulatory and simultaneous monitoring of intragastric bilirubin absorbance and pH values, and then they were divided into Bile Reflux positive group and Bile Reflux negative group. Severity of pathological changes in gastric mucosa including active inflammation, chronic inflammation, intestinal metaplasia, atrophy and dysplasia as well as Helicobacter pylori (H pylori) infection at the corpus, incisura and antrum were determined respectively according to update Sydney system criteria. The profiles of gastric mucosal lesions in the two groups were compared, and correlations between time-percentage of gastric bilirubin absorbance >0.14 and severity of gastric mucosal lesions as well as time-percentage of gastric pH >4 were analyzed respectively.

RESULTS: Thirty-eight patients (21 men and 17 women, mean age 44.2 years, range 25-61 years) were found existing with Bile Reflux (gastric bilirubin absorbance >0.14) and 11 patients (7 men and 4 women, mean age 46.2 years, range 29-54 years) were Bile Reflux negative. In dyspepsia patients with Bile Reflux, the mucosal lesions such as active inflammation, chronic inflammation, intestinal metaplasia, atrophy or H pylori infection in the whole stomach, especially in the corpus and incisura, were significantly more severe than those in dyspepsia patients without Bile Reflux. Moreover, the Bile Reflux time was well correlated with the severity of pathological changes of gastric mucosa as well as H pylori colonization in the near-end stomach, especially in the corpus region. No relevance was found between the time of Bile Reflux and pH >4 in gastric cavity.

CONCLUSION: Bile Reflux contributes a lot to mucosal lesions in the whole stomach, may facilitate H pylori colonization in the corpus region, and has no influence on acid-exposing status of gastric mucosa in patients with dyspepsia or chronic gastritis.

prevalence of Bile Reflux in gastroesophageal Reflux disease patients not responsive to proton pump inhibitors

Prevalence of Bile Reflux in gastroesophageal Reflux disease patients not responsive to proton pump inhibitors