title: Bilirubin as a tracer for detecting gastroesophageal reflux.
abstract: OBJECTIVE
  The usefulness of intraesophageal monitoring of bilirubin, in diagnosing gastroesophageal reflux, was studied.
  
  
  METHODS
  Bilirubin concentration and pH at 5 cm oral and anal to the esophagogastric junction were monitored for 24 hours in 19 patients with reflux esophagitis. The duration of bilirubin presented and pH less than 4.0 were obtained as the holding time (HT) of bilirubin and acid, respectively.
  
  
  RESULTS
  There was no difference between HT of bilirubin and acid in the stomach and esophagus. In the stomach, HT of bilirubin did not correlate with acid. Whereas, in both of bilirubin and acid, HT in the esophagus correlated significantly with that in the stomach. The correlation was more definite for bilirubin than acid.
  
  
  CONCLUSIONS
  Bilirubin and acid presented in the upper stomach for sufficient period independently. Bilirubin monitoring was useful to evaluate the etiology of damaging the esophageal mucosa and causes of symptoms by estimating duodenogastro-esophageal reflux, which has synergistic effect with acid.
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Medical School, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Osugi
authors.forename: M
authors.initials: M
authors.lastname: Higashino
authors.forename: S
authors.initials: S
authors.lastname: Kaseno
authors.forename: N
authors.initials: N
authors.lastname: Takada
authors.forename: M
authors.initials: M
authors.lastname: Takemura
authors.forename: M
authors.initials: M
authors.lastname: Ueno
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Fukuhara
authors.forename: Y
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: H
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000032:analysis* / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic
chemical_list: D015415:Biomarkers; D001663:Bilirubin