Is Gastroesophageal Reflux Disease Influenced by Duodenogastric Reflux ?

Abstract

BACKGROUND: It is well known that the gastroesophageal reflux is a frequent disease in medical practice. A lot of factors are involved in its pathogenesis. The aim of our study was to find out if the duodenogastric reflux is one of these factors. We also looked for the pathological conditions associated with duodenogastric reflux. MATERIAL AND METHODS: We studied a lot of 59 cases (30 females and 29 males) with ages between 39 and 54 years old suffering from gastroesophageal reflux disease (GERD). GERD, duodenogastric reflux were confirmed by upper gastrointestinal endoscopy. The abdominal ultrasound exam were used to evaluate the duodenal and gallbladder motility (ejection fraction, EF). The severity of GERD was appreciated using GERD Q-score. RESULTS: The women to men ratio was 30 to 29 and the mean age was 42 ±2 years. Cholesterolosis was found in 45.7% (n=27) from the patients. From these patients, 92.6% (n=25) had a ejection fraction (EF) above normal (hyperkinesia) and only two patients had normal gallbladder motility. From the patients with cholesterolosis, 20 (74%) had duodenogastric reflux. The other 32 patients without cholesterolosis had no duodenogastric reflux neither. We noted a strong statistical correlation between the cholesterolosis and duodenogastric reflux (P=1,115x10 -8 ). The duodenogastric reflux was found in 33.89% (n=20) from the patients and half of them (n=10) had associated esophagitis; we found a strong statistical correlation between duodenogastric reflux and esophagitis: P=1,543x10 -13 . All the patients had GERD Q-scores higher than 7 points; the mean score was 11.25±4.04 points (range 8-18). The mean Q-score value for the cases with duodenogastric reflux was 16.2±3.37; the cases without duodenogastric reflux (n=39) had a mean Q-score of 9.2±1.23 (P=3,138x10 -9 ). CONCLUSION: These results suggest that biliary disease can contribute to the duodenogastric reflux and the duodenogastric reflux aggravates gastroesophageal reflux.

Characteristics of Gastroesophageal Reflux Disease (GERD) Patients at RSUP Dr. M. Djamil Padang Period 2018-2021

“…This condition will cause atypical GERD symptoms, such as bloating, nausea, and vomiting. 33 In this study, blood HDL levels were abnormal in 29 patients (87.80%). This finding supported Kallel et al, which found 61.1% of GERD patients had abnormal HDL levels.…”

“…Mocanu et al described the mean LDL level in GERD patients as 112 mg/dL, above the normal level. 33 Hypertriglyceridemia is the leading cause of other lipid disruption due to late triglyceride-rich lipoprotein clearance and the formation of small dense LDL. Obesity can disturb lipolysis with a decrease of LPL in adipose tissue.…”

Morphological Changes in the Upper Part of Digestive Tract in a Case of Experimental Duodenogastric Reflux

“…The bile or alkaline reflux is a well-known retrograde spillage of bile from duodenum into the anatomically highly situated organs -stomach, esophagus and oral cavity. If reflux of the gastric contents into esophagus is considered being normal phenomena -the so-called physiological reflux, a bile reflux is associated with diseases [4][5][6][7]. However, some of authors consider duodeno-gastric reflux (DGR) to be a compensatory adaptive mechanism in a case of high pH in the stomach [8][9][10].…”