Spontaneous enterogastric reflux gastritis and esophagitis.
Enterogastric reflux gastritis and esophagitis is best known after gastric resections and pyloroplasty but it also occurs spontaneously in the nonoperated patient. Forty-two patients are presented who meet the criteria for the diagnosis: constant burning epigastric pain, worse after meals, unrelieved by antacids and diet; endoscopic demonstration of a gastric bile pool; endoscopic biopsy proof of gastritis and esophagitis; and hypochlorhydria. Patients with mild and moderate stages of the disease can benefit from metoclopramide therapy which improves the gastric emptying mechanism. Of the surgical patients with intractable symptoms, 90% were women, 90% had marked hypochlorhydria, 83% had biliary disease, current or remote, and 50% had anemia. With vagotomy, antrectomy, and Roux-Y anastomosis 45-60 cm downstream, the clinical response has been most encouraging.
D002760:Cholangiopancreatography, Endoscopic Retrograde; D004383:Duodenogastric Reflux / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004941:Esophagitis / Q000150:complications*; D005260:Female; D005743:Gastrectomy; D005756:Gastritis / Q000150:complications*; D006801:Humans; D010146:Pain / Q000209:etiology; D010437:Peptic Ulcer / Q000175:diagnosis / Q000601:surgery; D014628:Vagotomy