Novel approach to quantify duodenogastric reflux in healthy volunteers and in patients with type I gastric ulcer.

Abstract

SUMMARY A new method is described which allows simultaneous measurement of gastric emptying and duodenogastric reflux and avoids transpyloric intubation. After intragastric instillation of a liquid lipid meal in six healthy volunteers the fractional gastric emptying rate was 2.9±0.3 in the upright and 2.5±0 6 SEM x1T2/min in the supine position, respectively (p>0.5). The duodenogastric reflux rate (expressed as fraction of the intraduodenal amount of duodenal marker) was 0.30 (range 0.03-081) and 0.22 (0.01-0.55) x102/min, respectively (p>0.2). Atropine (40 ,g/kg) decreased the supine gastric emptying rate to 1.1 ±02 (p<005) and increased the supine duodenogastric reflux rate to 2.74 (0.04-9.80) x 102/min (p<005). Fasting duodenogastric reflux rate was similar in the supine and upright position, 0.49 (0.04-0.89) and 0.42 (0.06-0.97) x 102/min, respectively (p>0.5). Fractional gastric emptying rate was similar in 10 volunteers and 17 patients with type I gastric ulcer (21±04 vs 1.7±0.2 SEM x 10-2/min, p>0O2). Their duodenogastric reflux rates were also similar, 0-65 (0.01-5.24) vs 1.10 (0.01-10.83)x102/min (p>05). We conclude therefore that (1) gastric emptying and both fasting and postprandial duodenogastric reflux are independent of the posture; (2) fasting and postprandial reflux are of similar magnitude; (3) atropine shows gastric emptying and increases duodenogastric reflux; and (4)

Effect of a Transpyloric Tube on Gastric Emptying and Duodenogastric Reflux in the Dog

“…1 b, table I). This is in agreement with previous studies where a transpyloric tube did not affect gastric emptying in man [10,11] and dog [12], A lipid meal was chosen for the study because it is emptied slower than meals of glucose or protein [13]. Therefore, any effect of a trans pyloric tube should be easier to detect with a lipid than with another type of meal.…”

Intragastric Bile Acids in Patients with Gastric Ulcer and with Gastric Cancer

“…Evidence exists indicating that a chronic increase of DGR induces inflammatory lesions in the gastric mu cosa [4,22], and several studies have shown a relation between the existence of chronic gastritis and the devel opment of cancer [13][14][15][16][17], However, the results of the present study indicate that nonoperated patients with type I gastric ulcer or with gastric cancer in an advanced stage do not have a significant increase in the amount of BA refluxed into the stomach, in agreement with other recent studies [23][24][25]. Moreover, total mean values were slightly higher in the ulcer group than in the cancer group.…”

24-Hour Intragastric pH Measurement in the Quantification of Duodenogastric Reflux

“…Others [36,37] attributed this high percentage to errors in the interpretation of the isotopic images, due to the superpo sition of the left liver lobe on the gastric fundus and the ascending portion of the duodenum on the antrum. In our series, in the control group, the mean size of reflux areas (pH > 4) and that of bile acids are very low.…”

“…With regard to the reflux intensity we used the calcu lation of areas of pH greater or less than 4 which, in our opinion, gives a more exact reading of the intensity of the DGR episodes than of the duration, a method used by other authors [30,31], As occurs with gastroesophageal reflux, DGR may be found in healthy subjects without there being any patho logical significance [35][36][37], With regard to the fre quency of DGR, some authors [35], using isotopic meth ods, found DGR in 40-60% of healthy subjects. Others [36,37] attributed this high percentage to errors in the interpretation of the isotopic images, due to the superpo sition of the left liver lobe on the gastric fundus and the ascending portion of the duodenum on the antrum.…”