Search

Objective: To study the diadynamic method of primary bile reflux gastritis., Methods: Endoscopy, histologic examination, symptom analysis and 24-hour gastritic bilirubin monitoring with Bilitec 2000 were performed in 20 healthy subjects (HS) and 42 patients with symptoms of abdominal pain, abdominal distention, nausea and bile vomiting., Results: The total fraction time of bile reflux was higher in 42 patents than in 20 HS [(17.68 +/- 17.89)% vs. (2.92 +/- 2.39)%, P < 0.01]. 23 (55%) of 42 patients showed pathologic duodenogastric reflux (DGR). The incidence of pathologic DGR detected by Bilitec2000 in bile dyed mucous lake, antral mucosal erosion, bile dyed mucous lake accompanied with erosion and bile dyed mucous lake accompanied with middle-hyperemia of antral mucosae found in endoscopy were 86%, 88%, 8/8 and 85% respectively. The diagnosis of bile reflux gastritis (BRG) could be established if the patients with bile dyed mucous lake accompanied with erosion and/or middle-hyperemia of antral mucosae were found to be pathologic DGR. With this criterion, 11 patients were BRG in 42 patients in this study. The active inflammation of antral mucosae in the patients with BRG that without Helicobacter pylori (Hp) infection was more severe than that in the patients with physiologic DGR that without Hp infection significantly (P < 0.05). The symptoms of abdominal distention, nausea and bile vomiting in the patients with BRG were more severe significantly than those in the patients with physiologic DGR respectively (P < 0.05)., Conclusions: Final diagnosis of BRG can be made for the integrity stomach if the patients with bile dyed mucous lake accompanied with erosion and/or middle-hyperemia of antral mucosae were found to be pathologic DGR by Bilitec 2000.

Objective: To evaluate the features of gastroesophageal reflux disease (GERD) in elderly patients., Methods: 72 patients with GERD were investigated for the history of illness and the results of gastroscopy and 24 hours esophageal bile monitoring of 54 patients were simultaneously randomized to undergo ambulatory pH monitoring. The degrees of esophagitis were graded according to endoscopic findings., Results: Obesity was found in 48% of the elderly group (more than 65 years old) and 49% of the control group (less than 65 years old). There were longer acid and bile reflux time and higher frequency (65%) of hiatal hernia in the elderly, and more patients (35%) had complicated severe grade esophagitis. There were longer time of bile reflux and the higher incidence (76%) of both acid and bile reflux in elderly group than in control group (P < 0.05). But the acid reflux time (%) was similar in two groups (P > 0.05)., Conclusions: The GERD in elderly patients may be associated with obesity and hiatal hernia. The features of elderly GERD patients are high frequency of erosive esophagitis, and high frequency of both acid and bile reflux, as well as longer history of bile reflux time.

Objective: To evaluate the therpeutic effect of Danwei capsule in treating bile regurgitational gastritis., Methods: One hundred and thirty-four patients with bile regurgitational gastritis were divided into two groups. Danwei capsule was used in therapeutic group and Motilium was used in control group., Results: The total effective rate in therapeutic group was 92.59%, and 71.70% in control group (P < 0.01). The improvement in symptoms, physical findings and bile regurgitation in therapeutic group was better than that of control., Conclusion: Curative effect of Danwei capsule was better than that of Motilium, which should be used widely.

Thirty patients with bile reflux gastritis, proven by gastroscopy and Milk 99mTc-EHIDA Test, were studied and their clinical features were compared with those of patients with non-bile reflux gastritis. The symptoms were similar in both groups of patients, whereas histologically in bile reflux gastritis there were more hyperemia of mucosa, more obvious edema in lamina propria and more polymorphonuclear infiltration. Furthermore, in bile reflux gastritis the histological changes were more severe in the antrum and decreased in severity toward the cardia. Acid secretion was significantly lower in patients with bile reflux gastritis than in patients with non-bile reflux gastritis while the serum gastrin level was significantly higher in the former than in the latter group. The authors suggest that there may be a vicious cycle among duodenogastric reflux, low level of gastric acidity and high level of serum gastrin. When duodenogastric reflux occurs, not only the bile salts damage the gastric mucosa and subsequently cause the back diffusion of hydrogen ion but also the alkaline duodenal juice neutralizes the gastric acid, resulting in decrease of gastric acidity. The bile salts and low acidity can stimulate the release of serum gastrin which antagonizes the effects of cholecystokinin and secretin on pyloric tone and aggravates the duodenogastric reflux.