Mechanisms underlying duodeno-gastric reflux in man

Authors: koek g. h.; vos r.; sifrim d.; cuomo r.; janssens j.; tack j.

Source: Neurogastroenterology and Motility, Volume 17, Number 2, April 2005 , pp. 191-199(9)

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Abstract:

Background:

Recent studies suggest that duodeno-gastro-oesophageal reflux (DGER) contributes to the occurrence of reflux oesophagitis and Barrett's oesophagus. The mechanisms underlying duodeno-gastric reflux (DGR), a prerequisite for DGER, are poorly understood. Aims:

To study the occurrence of DGR in relation to interdigestive and postprandial gastroduodenal motility. Subjects and methods:

Ten healthy subjects underwent stationary gastroduodenal manometry with simultaneous duodenal and antral Bilitec^® recording 4 h before and 5 h after ingestion of a liquid meal. Eight volunteers underwent the same study, with administration of erythromycin postprandially. Results:

During the interdigestive phase II, all volunteers had short DGR episodes. Postprandially, DGR occurred in all subjects, on average 39 ± 28 min after the start of the meal, and was cleared from the stomach after 242 ± 23 min. Induction of increased antral motility and of a premature phase III, by administration of erythromycin, was associated with faster gastric DGR clearance. However, there was no direct temporal relationship between erythromycin-induced gastric phase III and erythromycin-induced DGR clearance. Conclusion:

In healthy subjects, duodenogastric reflux occurs sporadically in the interdigestive state and is a normal phenomenon in the postprandial period. Erythromycin induces faster clearance of DGR from the stomach, which depends on enhanced antral contractile activity rather than premature phase III.

Keywords: duodenal content; duodeno-gastric reflux; gastro-oesophageal reflux disease; manometry; motility

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2982.2004.00633.x

Publication date: 2005-04-01