The Effect of Primary Duodenogastric Bile Reflux on the Presence and Density of Helicobacter pylori and on Gastritis in Childhood

Abstract

Background and Objectives: Although there are many studies that investigate the relationship between duodenogastric reflux (DGR) and Helicobacter pylori in adult patients, the reported data are contradictory. In addition, there are very few studies in the literature investigating the relationship between DGR and H. pylori in the pediatric age group. In the present study, we investigated the effect of primary DGR on H. pylori and gastritis. Materials and Methods: A total of 361 patients who were referred to the clinic of our hospital with dyspeptic complaints who had an upper gastrointestinal system endoscopy and a gastric biopsy were included in the study. Results: DGR was detected in 45 cases, and 316 cases that did not have DGR were considered as the control group. Comparisons were made between the DGR cases and the control group in terms of risk factors (age, gender), the presence and density of H. pylori, and the presence and severity of gastritis. The average age of the patients who were included in the study was 11.6 ± 4.6 years. A total of 128 (36%) of the cases were male and 233 (64%) were female. DGR was present in 45 (13%) of the cases. The average age of the patients with DGR was 13.9 ± 3.1 years, the average age of the control group was 11.3 ± 4.7, and there were statistically significant differences (p < 0.001). No significant differences were detected in terms of gender between DGR and the control group (p > 0.05). H. pylori (+) was detected in 29 (64%) of patients with DGR, and in 202 (64%) of the control group. No significant differences were detected between H. pylori prevalence (p = 0.947). Gastritis was detected in 37 (82%) of the patients with DGR, and in 245 (77%) of the control group (p = 0.476). No significant differences were detected between the presence and density of H. pylori, gastritis presence, severity and DGR (p > 0.05). Conclusions: The ages of patients with DGR were significantly higher than in the control group, and advanced age was shown to be a risk factor for primary DGR. It was found that the presence of DGR has no effect on the presence and severity of H. pylori. Given this situation, we consider it is important to eradicate H. pylori infection, especially in the case where H. pylori is present together with DGR.

Helicobacter pylori infection over bile reflux: No influence on the severity of endoscopic or premalignant gastric lesion development

“…Duodenogastric reflux (DGR, bile reflux) consists of a retrograde passage of alkaline duodenal and pancreatic content into the stomach, which can lead to mucous barrier disruption and direct chemical damage to the surface gastric epithelium. DGR is common after gastric surgery, cholecystectomy and pyloroplasty, but it can also occur due to antroduodenal motility disorder (primary DGR) (1,2). Primary bile reflux does not have a standardized diagnosis.…”

The Relationship between Primary Duodenogastric Reflux and <b><i>Helicobacter pylori</i></b> Gastritis in Children

“…However, Vere et al [15] found biliary reflux more commonly in the elderly (50–80 years) and attributed this finding to a higher incidence of stomach surgery, which is a risk factor for DGR in these patients. In a study by Agin et al [6] on children, DGR was demonstrated to be significantly more common in older children. Likewise, in the present study, the mean age of patients with biliary reflux was found to be significantly higher than that of patients without reflux.…”

“…There are a few studies investigating the relationship between DGR and H. pylori in adults, but a paucity of studies involving children. Most of the studies on adults and few studies on children propose that the presence of DGR decreases H. pylori colonization, while the presence of H. pylori increases the prevalence of DGR by impairing antroduodenal motility [1, 2, 6, 8-10]. The aim of the present study was to investigate the relationship between primary DGR and H. pylori prevalence , degree of colonization, and the presence and severity of gastritis in the pediatric population.…”

Evaluation of Changes in Gastric Ph and Gastrine Concentrations in Horses Subjected to Inhalatory General Anesthesia in Dorsal Decubitus

“…In this case, the presence of bile salts would be responsible for the alkaline pH observed in post-anesthetic evaluations. Although not performed in this study, the resulting analysis of gastric juice with pHmetry would be interesting to demonstrate the presence and concentration of bile salts, diagnosing duodenogastric re ux [31][32][33].…”