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[Duodenogastric and gastroesophageal bile reflux].
J Chir (Paris) 2006 Nov-Dec; 143(6):355-65JC

Abstract

This study reviews current data regarding duodenogastric and gastroesophageal bile reflux-pathophysiology, clinical presentation, methods of diagnosis (namely, 24-hour intraluminal bile monitoring) and therapeutic management. Duodenogastric reflux (DGR) consists of retrograde passage of alkaline duodenal contents into the stomach; it may occur due to antroduodenal motility disorder (primary DGR) or may arise following surgical alteration of gastoduodenal anatomy or because of biliary pathology (secondary DGR). Pathologic DGR may generate symptoms of epigastric pain, nausea, and bilious vomiting. In patients with concomitant gastroesophageal reflux, the backwash of duodenal content into the lower esophagus can cause mixed (alkaline and acid) reflux esophagitis, and lead, in turn, to esophageal mucosal damage such as Barrett's metaplasia and adenocarcinoma. The treatment of DGR is difficult, non-specific, and relatively ineffective in controlling symptoms. Proton pump inhibitors decrease the upstream effects of DGR on the esophagus by decreasing the volume of secretions; promotility agents diminish gastric exposure to duodenal secretions by improving gastric emptying. In patients with severe reflux resistant to medical therapy, a duodenal diversion operation such as the duodenal switch procedure may be indicated.

Authors+Show Affiliations

Service de Chirurgie Générale, Digestive et de Transplantation Hépatique, Hôpital de la Croix-Rousse - Lyon. jean-yves.mabrut@chu-lyon.frNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

fre

PubMed ID

17285081

Citation

Mabrut, J Y., et al. "[Duodenogastric and Gastroesophageal Bile Reflux]." Journal De Chirurgie, vol. 143, no. 6, 2006, pp. 355-65.
Mabrut JY, Collard JM, Baulieux J. [Duodenogastric and gastroesophageal bile reflux]. J Chir (Paris). 2006;143(6):355-65.
Mabrut, J. Y., Collard, J. M., & Baulieux, J. (2006). [Duodenogastric and gastroesophageal bile reflux]. Journal De Chirurgie, 143(6), pp. 355-65.
Mabrut JY, Collard JM, Baulieux J. [Duodenogastric and Gastroesophageal Bile Reflux]. J Chir (Paris). 2006;143(6):355-65. PubMed PMID: 17285081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Duodenogastric and gastroesophageal bile reflux]. AU - Mabrut,J Y, AU - Collard,J M, AU - Baulieux,J, PY - 2007/2/8/pubmed PY - 2007/3/30/medline PY - 2007/2/8/entrez SP - 355 EP - 65 JF - Journal de chirurgie JO - J Chir (Paris) VL - 143 IS - 6 N2 - This study reviews current data regarding duodenogastric and gastroesophageal bile reflux-pathophysiology, clinical presentation, methods of diagnosis (namely, 24-hour intraluminal bile monitoring) and therapeutic management. Duodenogastric reflux (DGR) consists of retrograde passage of alkaline duodenal contents into the stomach; it may occur due to antroduodenal motility disorder (primary DGR) or may arise following surgical alteration of gastoduodenal anatomy or because of biliary pathology (secondary DGR). Pathologic DGR may generate symptoms of epigastric pain, nausea, and bilious vomiting. In patients with concomitant gastroesophageal reflux, the backwash of duodenal content into the lower esophagus can cause mixed (alkaline and acid) reflux esophagitis, and lead, in turn, to esophageal mucosal damage such as Barrett's metaplasia and adenocarcinoma. The treatment of DGR is difficult, non-specific, and relatively ineffective in controlling symptoms. Proton pump inhibitors decrease the upstream effects of DGR on the esophagus by decreasing the volume of secretions; promotility agents diminish gastric exposure to duodenal secretions by improving gastric emptying. In patients with severe reflux resistant to medical therapy, a duodenal diversion operation such as the duodenal switch procedure may be indicated. SN - 0021-7697 UR - https://www.unboundmedicine.com/medline/citation/17285081/[Duodenogastric_and_gastroesophageal_bile_reflux]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/MDOI-JCHIR-11-12-2006-143-6-0021-7697-101019-200609592 DB - PRIME DP - Unbound Medicine ER -