[The role of duodenogastroesophageal reflux in gastroesophageal reflux disease].
OBJECTIVE
To investigate the role of duodenogastroesophageal reflux (DGER) in the pathogenesis of gastroesophageal reflux disease (GERD) and its value for the diagnosis of non-erosive reflux disease (NERD).


METHODS
95 cases of GERD were divided into two groups according to endoscopic findings: reflux esophagitis (RE) (n = 51) and NERD (n = 44). Simultaneous 24-hour esophageal pH and bilirubin monitoring were performed.


RESULTS
The index values of DGER in RE group such as percent of time with Abs > 0.14, total reflux time and time with reflux > 5 min were 19.05 +/- 23.44, 30.56 +/- 34.04 and 5.90 +/- 6.37 respectively, they were significantly higher than those of NERD, 7.26 +/- 11.08, 15.68 +/- 20.92 and 2.59 +/- 3.57, respectively (P < 0.05), but no significant difference was found in acid reflux. The occurrence of DGER was more common in more severe esophagitis. Isolated DGER were found in 18.2% of NERD, and combined bilirubin monitoring could elevate the positive diagnosis rate of NERD from 65.9% to 84.1%.


CONCLUSIONS
DGER could be present isolatedly and played an obvious role in the genesis of RE and GERD symptoms. Simultaneous 24-hour esophageal pH and bilirubin monitoring were helpful for the diagnosis of NERD.
Xu
Xiao-rong
XR
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. xiaorongxu123@msn.com
Li
Zhao-shen
ZS
Xu
Guo-ming
GM
Zou
Duo-wu
DW
Yin
Ning
N
Ye
Ping
P
D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D004383:Duodenogastric Reflux / Q000150:complications*; D020776:Endoscopes, Gastrointestinal; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000209:etiology*; D004947:Esophagus / Q000737:chemistry / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D001663:Bilirubin