Skip to main content
Log in

Long-term ambulatory enterogastric reflux monitoring

Validation of a new fiberoptic technique

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

A new technique for the long-term ambulatory detection of enterogastric and nonacid gastroesophageal reflux has been conceived, developed, and validated. It is based on the use of a fiberoptic sensor that utilizes the optical properties of bile.In vitro studies have shown good precision, good stability, sensitivity of 2.5 μmol/liter bilirubin concentration, as well as a useful working range of 2.5–100 μmol/liter bilirubin concentration.In vivo studies have been performed in 29 subjects. Simultaneous gastric aspirations have allowed a comparison of fiberoptic system measurements both with spectrophotometric analysis and bile acid concentrations of corresponding gastric juice samples. Linear correlations were shown between fiberoptic assessment and both spectrophotometric and bile acid concentration findings (P<0.01). Simultaneous assessment of reflux with the fiberoptic system and cholescintigraphy has shown a 92.9% concordance as regards the presence or absence of reflux. Present results imply that the fiberoptic system is an important tool for the understanding of the clinical relevance of enterogastric and nonacid gastroesophageal reflux.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Keane FB, Dimagno EP, Malagelada JR: Duodenogastric reflux in humans: its relationship to fasting antroduodenal motility and gastric, pancreatic and biliary secretion. Gastroenterology 81:726–731, 1981

    Google Scholar 

  2. Fuchs KM, DeMeester TR, Hinder RA, Stern HJ, Barlow AP, Gupta NC: Computerized identification of pathologic duodenogastric reflux using 24 hour gastric pH monitoring. Ann Surg 213:13–20, 1991

    Google Scholar 

  3. DuPlessis DJ: Pathogenesis of gastric ulceration. Lancet 1:974–978, 1965

    Google Scholar 

  4. Dixon MF: Progress in pathology of gastritis and duodenitis.In Current Topics in Pathology. GT Williams (ed). Berlin, Springer-Verlag, 1990, pp 1–39

    Google Scholar 

  5. Kalima TV: Reflux gastritis unrelated to gastric surgery. Scand J Gastroenterol 17 (suppl 79):66–71, 1982

    Google Scholar 

  6. Hopewood D, Bateson MC, Milne G, Bouchier IAD: Effects of bile acids and hydrogen ion on the fine structure of oesophageal epithelium. Gut 22:306–311, 1981

    Google Scholar 

  7. Cortesini C, Pucciani F: Usefulness of combined gastric and esophageal pH monitoring in detecting gastroesophageal alkaline and mixed reflux. Eur Surg Res 16:378–383, 1984

    Google Scholar 

  8. Attwood SEA, DeMeester TR, Bremner CG, Barlow AP, Hinder RA: Alkaline gastroesophageal reflux: Implication in the development of complications in Barrett's columnarlined lower esophagus. Surgery 106:764–770, 1989

    Google Scholar 

  9. Bechi P, Balzi M, Becciolini A, Amorosi A, Scubla E, Giaché V, Mazzanti R, Tonelli P, Cortesini C: Gastric cell proliferation kinetics and bile reflux after partial gastrectomy. Am J Gastroenterol 86:1424–1432, 1991

    Google Scholar 

  10. Hostein J, Bost R, Faure H, Lachet B, Fournet J: Valeur diagnostique de la pHmetrie gastrique au cours du reflux duodeno-gastrique. Gastroenterol Clin Biol 11:206–211, 1987

    Google Scholar 

  11. Bechi P, Falciai R, Baldini F, Cosi F, Pucciani F, Boscherini S: A new fiber optic sensor for ambulatory entero-gastric reflux detection.In Fiber Optic Medical and Fluorescent Sensors and Applications, Proc SPIE 1648. A Katzir (). Bellingham, SPIE, 1992, pp 130–135

    Google Scholar 

  12. Mashige F, Tanaka N, Maki A, Kamei S, Yamanaka N: Direct spectrophotometry of total bile acids in serum. Clin Chem 27:1352–1356, 1981

    Google Scholar 

  13. Tolin RD, Malmud LS, Stelzer F, Menin R, Makler PT, Applegate G, Fisher RS: Enterogastric reflux in normal subjects and patients with Billroth II gastroenterostomy. Measurement of enterogastric reflux. Gastroenterology 77:1027–1033, 1979

    Google Scholar 

  14. Humphrey CS, Cuschieri A: The stomach and duodenum.In Essential Surgical Practice. A Cuschieri, GR Giles, AR Moossa (eds). London, Wright, 1988, pp 955–988

    Google Scholar 

  15. Stocker DL, Williams JG: Alkaline reflux oesophagitis. Gut 32:1090–1092, 1991

    Google Scholar 

  16. Gotley DC, Morgan AP, Ball D, Owen RW, Cooper MJ: Composition of gastro-oesophageal refluxate. Gut 32:1093–1099, 1991

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported in part by a grant from the Ministero della Universitá e della Ricerca Scientifica e Tecnologica.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bechi, P., Pucciani, F., Baldini, F. et al. Long-term ambulatory enterogastric reflux monitoring. Digest Dis Sci 38, 1297–1306 (1993). https://doi.org/10.1007/BF01296082

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01296082

Key Words

Navigation