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Duodenogastric and non acid gastro-oesophageal reflux in patients with reflux oesophagitis.
Hepatogastroenterology 1995 Jul-Aug; 42(4):360-6H

Abstract

BACKGROUND/AIM

The role and the identification criteria of non acid gastro-oesophageal reflux (GOR) are still debated. Moreover, the relationship between nonacid GOR and gastric alkalinizations, particularly if secondary to duodeno-gastric reflux is yet to be defined.

MATERIALS AND METHODS

One hundred and forty one patients affected by GORD symptoms and oesophagitis entered the study. Oesophagitis was divided into four categories, according to a modified Savary and Miller classification. Acid (pH<4), alkalacid (4<pH>7), alkaline (pH>7) GOR and duodenogastric reflux were measured by means of ambulatory three channel esophago-gastric pH monitoring with a combined analysis of the pH traces recorded in the oesophagus fundus and antrum.

RESULTS

Total time percentage (T%) of acid GOR was significantly greater in patients than in healthy volunteers (HV) and between groups of patients in direct relation with the severity of the oesophagitis. Alkaline GOR was hardly detectable in every class of esophagitis. Alkalacid GOR increased with the grade of severeness of oesophagitis. Alkalacid GOR occurred prevalently in the postprandial period; it was only 8% of the time in patients with mild reflux oesophagitis and even less in patients with moderate or severe oesophagitis. The 24 hr total time percentage of duodenogastric reflux was similar in the patients and healthy volunteer groups. The frequency distribution in 0.1 intervals of fundic and antral pH samples showed a greater number of them in the acid range (0.8-1.2) in the patients than in healthy volunteer group (0.0006<p<0.05). The frequency distribution of alkalacid (4<pH<7) and alkaline (pH>7) samples was similar in patients and in healthy volunteers.

CONCLUSIONS

Our findings demonstrate that alkaline GOR is rare in GORD patients and that non acid GOR has a minor role in the pathophysiology of reflux esophagitis.

Authors+Show Affiliations

Istituto di Clinica Chirurgica II, Pol. S. Orsola Universita di Bologna, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8586369

Citation

Mattioli, S, et al. "Duodenogastric and Non Acid Gastro-oesophageal Reflux in Patients With Reflux Oesophagitis." Hepato-gastroenterology, vol. 42, no. 4, 1995, pp. 360-6.
Mattioli S, Felice V, Pastina M, et al. Duodenogastric and non acid gastro-oesophageal reflux in patients with reflux oesophagitis. Hepatogastroenterology. 1995;42(4):360-6.
Mattioli, S., Felice, V., Pastina, M., Pilotti, V., D'Ovidio, F., Bacchi, M. L., & Gozzetti, G. (1995). Duodenogastric and non acid gastro-oesophageal reflux in patients with reflux oesophagitis. Hepato-gastroenterology, 42(4), pp. 360-6.
Mattioli S, et al. Duodenogastric and Non Acid Gastro-oesophageal Reflux in Patients With Reflux Oesophagitis. Hepatogastroenterology. 1995;42(4):360-6. PubMed PMID: 8586369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Duodenogastric and non acid gastro-oesophageal reflux in patients with reflux oesophagitis. AU - Mattioli,S, AU - Felice,V, AU - Pastina,M, AU - Pilotti,V, AU - D'Ovidio,F, AU - Bacchi,M L, AU - Gozzetti,G, PY - 1995/7/1/pubmed PY - 1995/7/1/medline PY - 1995/7/1/entrez SP - 360 EP - 6 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 42 IS - 4 N2 - BACKGROUND/AIM: The role and the identification criteria of non acid gastro-oesophageal reflux (GOR) are still debated. Moreover, the relationship between nonacid GOR and gastric alkalinizations, particularly if secondary to duodeno-gastric reflux is yet to be defined. MATERIALS AND METHODS: One hundred and forty one patients affected by GORD symptoms and oesophagitis entered the study. Oesophagitis was divided into four categories, according to a modified Savary and Miller classification. Acid (pH<4), alkalacid (4<pH>7), alkaline (pH>7) GOR and duodenogastric reflux were measured by means of ambulatory three channel esophago-gastric pH monitoring with a combined analysis of the pH traces recorded in the oesophagus fundus and antrum. RESULTS: Total time percentage (T%) of acid GOR was significantly greater in patients than in healthy volunteers (HV) and between groups of patients in direct relation with the severity of the oesophagitis. Alkaline GOR was hardly detectable in every class of esophagitis. Alkalacid GOR increased with the grade of severeness of oesophagitis. Alkalacid GOR occurred prevalently in the postprandial period; it was only 8% of the time in patients with mild reflux oesophagitis and even less in patients with moderate or severe oesophagitis. The 24 hr total time percentage of duodenogastric reflux was similar in the patients and healthy volunteer groups. The frequency distribution in 0.1 intervals of fundic and antral pH samples showed a greater number of them in the acid range (0.8-1.2) in the patients than in healthy volunteer group (0.0006<p<0.05). The frequency distribution of alkalacid (4<pH<7) and alkaline (pH>7) samples was similar in patients and in healthy volunteers. CONCLUSIONS: Our findings demonstrate that alkaline GOR is rare in GORD patients and that non acid GOR has a minor role in the pathophysiology of reflux esophagitis. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/8586369/Duodenogastric_and_non_acid_gastro_oesophageal_reflux_in_patients_with_reflux_oesophagitis_ L2 - https://medlineplus.gov/gerd.html DB - PRIME DP - Unbound Medicine ER -