Gastric emptying and duodeno-gastro-oesophageal reflux in gastro-oesophageal reflux disease.
BACKGROUND
Previous studies present conflicting results regarding relationship between gastric emptying and gastro-oesophageal reflux disease. Reflux of duodenal content to oesophagus is generally considered to be associated with more severe disease.


OBJECTIVE
To assess presence of a gastric emptying disorder in persons with reflux of duodenal contents to oesophagus and to identify any correlation with gastric emptying and oesophageal motility.


METHODS
A total of 15 subjects with (B+) and 15 subjects without (B-) bile reflux to oesophagus determined by 24-hour bilirubin monitoring were studied with scintigraphic solid gastric emptying and 24-hour oesophageal manometry.


RESULTS
There was no difference in lag phase [median 23.7 (range 10.8-44.0) vs 24.6 (8.1-40.1) min], half emptying time [74.6 (48.0-93.6) vs 82.8 (54.4-153.9) min] or emptying rate [0.89 (0.59-1.34) vs 0.83 (0.36-1. 15)%/min] for B- and B+ subjects, respectively. In addition, there was no difference in emptying rate of gastric fundus between B- and B+ subjects. Subjects with bile reflux had less effective oesophageal contractions of oesophageal body [9.4(3.3-37)%] compared to subjects without bile reflux [32(19-47)%, p = 0.002]. However, there was no correlation between oesophageal motility and gastric emptying.


CONCLUSIONS
Results suggest that a gastric emptying disorder is a less likely contributing cause of bile reflux to the oesophagus, but bile reflux is associated with less effective oesophageal motility.
Freedman
J
J
Division of Surgery, Karolinska Institutet, Danderyd Hospital, Sweden. Jacob.Freedman@kir.ds.sll.se
Grybäck
P
P
Lindqvist
M
M
Granström
L
L
Lagergren
J
J
Hellström
P M
PM
Jacobsson
H
H
Näslund
E
E
D000328:Adult; D000368:Aged; D001646:Bile / Q000378:metabolism; D001663:Bilirubin / Q000378:metabolism; D002940:Circadian Rhythm / Q000502:physiology; D004383:Duodenogastric Reflux / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D013223:Statistics as Topic
D001663:Bilirubin