Is Gastroesophageal Reflux Disease Influenced by Duodenogastric Reflux ?

IS GASTROESOPHAGEAL REFLUX DISEASE INFLUENCED BY DUODENOGASTRIC REFLUX ? (Abstract): BACKGROUND: It is well known that the gastroesophageal reflux is a frequent disease in medical practice. A lot of factors are involved in its pathogenesis. The aim of our study was to find out if the duodenogastric reflux is one of these factors. We also looked for the pathological conditions associated with duodenogastric reflux. MATERIAL AND METHODS: We studied a lot of 59 cases (30 females and 29 males) with ages between 39 and 54 years old suffering from gastroesophageal reflux disease (GERD). GERD, duodenogastric reflux were confirmed by upper gastrointestinal endoscopy. The abdominal ultrasound exam were used to evaluate the duodenal and gallbladder motility (ejection fraction, EF). The severity of GERD was appreciated using GERD Q-score. RESULTS: The women to men ratio was 30 to 29 and the mean age was 42 ±2 years. Cholesterolosis was found in 45.7% (n=27) from the patients. From these patients, 92.6% (n=25) had a ejection fraction (EF) above normal (hyperkinesia) and only two patients had normal gallbladder motility. From the patients with cholesterolosis, 20 (74%) had duodenogastric reflux. The other 32 patients without cholesterolosis had no duodenogastric reflux neither. We noted a strong statistical correlation between the cholesterolosis and duodenogastric reflux (P=1,115x10 -8 ). The duodenogastric reflux was found in 33.89% (n=20) from the patients and half of them (n=10) had associated esophagitis; we found a strong statistical correlation between duodenogastric reflux and esophagitis: P=1,543x10 -13 . All the patients had GERD Q-scores higher than 7 points; the mean score was 11.25±4.04 points (range 8-18). The mean Q-score value for the cases with duodenogastric reflux was 16.2±3.37; the cases without duodenogastric reflux (n=39) had a mean Q-score of 9.2±1.23 (P=3,138x10 -9 ). CONCLUSION: These results suggest that biliary disease can contribute to the duodenogastric reflux and the duodenogastric reflux aggravates gastroesophageal reflux.