Is bile reflux at endoscopy a significant finding?

I A Eyre-Brook; A M Holroyd; A G Johnson

Home/Archive/PubMed

PubMed · 6588514

Is bile reflux at endoscopy a significant finding?

I A Eyre-Brook·A M Holroyd·A G Johnson

View original source ↗Export metadata ↓

Abstract

Postprandial duodenogastric reflux (DGR) was assessed scintigraphically in 10 patients with postprandial dyspepsia and endoscopic evidence of bile reflux (EBR) and in two control groups comprising seven patients with similar symptoms but normal endoscopic findings and 10 asymptomatic subjects without gastrointestinal pathology. DGR of iminodiacetic acid (IDA) after a liquid Lundh meal (250 ml) was assessed dynamically with 1 minute scintiscans and DGR expressed as the percentage of IDA secreted by the liver which appeared in the gastric region. DGR varied from 0-5% in asymptomatic controls and from 0-6% in dyspeptics without EBR. DGR in patients with EBR ranged from 0-16% but only two of 10 had values outside the normal range (0-5%).

Explore related subjects

Bile Reflux Biliary Tract Diseases Duodenogastric Reflux Dyspepsia Eating Endoscopy Humans Imino Acids Radionuclide Imaging Technetium Journal Article

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

I A Eyre-Brook, A M Holroyd, A G Johnson. 1984. Is bile reflux at endoscopy a significant finding?. https://pubmed.ncbi.nlm.nih.gov/6588514/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Regulation of the human mucin MUC4 by taurodeoxycholic and taurochenodeoxycholic bile acids in oesophageal cancer cells is mediated by hepatocyte nuclear factor 1alpha.

MUC4 (mucin 4) is a membrane-bound mucin overexpressed in the early steps of oesophageal carcinogenesis and implicated in tumour progression. We previously showed that bile acids, main components of gastro-oesophageal reflux and tumour promoters, up-regulate MUC4 expression [Mariette, Perrais, Leteurtre, Jonckheere, Hemon, Pigny, Batra, Aubert, Triboulet and Van Seuningen (2004) Biochem. J. 377, 701-708]. HNF (hepatocyte nuclear factor) 1alpha and HNF4alpha transcription factors are known to mediate bile acid effects, and we previously identified cis-elements for these factors in MUC4 distal promoter. Our aim was to demonstrate that these two transcription factors were directly involved in MUC4 activation by bile acids. MUC4, HNF1alpha and HNF4alpha expressions were evaluated by immunohistochemistry in human oesophageal tissues. Our results indicate that MUC4, HNF1alpha and HNF4alpha were co-expressed in oesophageal metaplastic and adenocarcinomatous tissues. Studies at the mRNA, promoter and protein levels indicated that HNF1alpha regulates endogenous MUC4 expression by binding to two cognate cis-elements respectively located at -3332/-3327 and -3040/-3028 in the distal promoter. We also showed by siRNA (small interfering RNA) approach, co-transfection and site-directed mutagenesis that HNF1alpha mediates taurodeoxycholic and taurochenodeoxycholic bile acid activation of endogenous MUC4 expression and transcription in a dose-dependent manner. In conclusion, these results describe a new mechanism of regulation of MUC4 expression by bile acids, in which HNF1alpha is a key mediator. These results bring new insights into MUC4 up-regulation in oesophageal carcinoma associated with bile reflux.

Bile Reflux↗

PubMed2006

[Chronic diseases after gastrointestinal surgery].

Gastrointestinal surgery may not only lead to early postoperative complications but also chronic consequences. These have therapeutic implications for affected patients. The kind and extent of surgical intervention determines the spectrum of postsurgical phenomena which may occur. These chronic consequences are due to changes in gastrointestinal anatomy, the synchronization of digestive processes, or the ability to digest and absorb food. In case of transplantation surgery, adverse effects of immunosuppression have to be considered. Sometimes, chronic consequences of surgical procedures are difficult to recognize. The knowledge of typical problems associated with gastrointestinal surgery is necessary to enable early and timely diagnosis and treatment. Some negative effects can be avoided by early therapeutic interventions. This article summarizes typical chronic consequences of gastrointestinal surgery.

Bile Reflux↗

PubMed2006

Posterior esophagopexy with dome formation to prevent reflux in interposed jejunal pouch reconstruction after total gastrectomy.

Jejunal pouch interposition (JPI) reconstruction after total gastrectomy has proven effective for improving postoperative quality of life; however, evaluation of bile reflux into the esophagus shows that the reflux of digestive juice is not sufficiently prevented. Therefore, in addition to the conventional reconstruction technique, we created an artificial pouch to prevent the reflux of digestive juice from the jejunal pouch into the esophagus, and performed a new surgical technique based on the Hill's posterior gastropexy. No postoperative complications were observed and the postoperative measurement showed a decrease in the duration of bile reflux into the esophagus. Thus, our new surgical procedure seems to effectively prevent bile reflux.

Bile Reflux↗