Medical treatment of duodenogastroesophageal reflux in postgastrectomy patients has been disappointing. Using ambulatory esophageal bilirubin monitoring, we evaluated the efficacy of cisapride in this disorder. Ten chronically symptomatic partial gastrectomy patients (5 Billroth I, 5 Billroth II; 8 men; average age 57) with duodenogastroesophageal reflux were randomized to four weeks of either placebo or cisapride (20 mg four times a day) in a double-blind crossover study. Significantly improved patients continued to take cisapride for an additional four months. Duodenogastroesophageal reflux was assessed at baseline and after four weeks on each therapy. Daily diary recorded symptoms and mean monthly scores were determined. Global symptom improvements were assessed at the end of each treatment period. Compared to placebo, cisapride significantly (P < 0.05) decreased duodenogastroesophageal reflux. Overall symptom improvements were assessed at the end of each treatment period. Compared to placebo, cisapride significantly (P < 0.05) decreased duodenogastroesophageal reflux. Overall symptoms improved in 70% of patients on cisapride compared to 10% on placebo (P < 0.01). Mean monthly scores significantly (P < 0.05) improved for abdominal pain, regurgitation, and belching. These symptoms remained improved after four months of chronic therapy. We conclude that cisapride significantly reduces duodenogastroesophageal reflux and results in short- and long-term symptom improvements in postgastrectomy patients and that cisapride offers the first successful medical therapy for duodenogastroesophageal reflux in postgastrectomy patients.

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analysis of 37 morphonuclear variables was performed to characterize differences 2 Institute of Interdisciplinary Research and Debetween: 1) chronic pancreatitis and pancreatic adenocarcinoma, and 2) primary velopment in Artificial Intelligence, Free Universclerosing cholangitis and cholangiocarcinoma. sity of Brussels, Brussels, Belgium. RESULTS. Chronic pancreatitis was distinguished from pancreatic adenocarcinoma3 Medical-Surgical Department of Gastroenter-(P°0.001); sensitivity and specificity were both estimated to be 82%. Primary ology, Erasme Hospital, Free University of Brussclerosing cholangitis was distinguished from cholangiocarcinoma (P°0.01); sensels, Brussels, Belgium.sitivity and specificity were estimated to be 82% and 85%, respectively.

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