Influences of Bile Reflux on Profile of Gastric Mucosal Lesions in Chronic Gastritis

Objective To investigate the influences of bile reflux on profiles of gastric mucosal lesions in patients with dyspepsia or chronic gastritis. Methods A total of 49 patients with dyspepsia and chronic gastritis underwent 24 h ambulatory and simultaneous monitoring of intragastric bilirubin absorbance and pH values, and then they were divided into bile reflux positive group and bile reflux negative group. Severity of pathological changes in gastric mucosa including active inflammation, chronic inflammation, intestinal metaplasia, atrophy and dysplasia as well as H. pylori(Hp) infection at the corpus, incisura and antrum was determined, respectively, according to the update Sydney system criteria. The profiles of gastric mucosal lesions in the two groups were compared, and correlations between time-percentage of gastric bilirubin absorbance 0.14 and severity of gastric mucosal lesions as well as time-percentage of gastric pH4 were analyzed, respectively. Results Thirty-eight patients were bile reflux positive and 11 patients were bile reflux negative. In dyspepsia patients with bile reflux, the mucosal lesions such as active inflammation, chronic inflammation, intestinal metaplasia, atrophy or H.pylori infection in the whole stomach, especially in the corpus and incisura, were significantly more severe than those in patients without bile reflux. Moreover, the bile reflux time was well correlated with the severity of pathological changes of gastric mucosa as well as Hp colonization in the near-end stomach, especially in the corpus region. No relevance was found between the time of bile reflux and pH4 in the gastric cavity. Conclusion Bile reflux contributes a lot to mucosal lesions in the whole stomach, and may facilitate HP colonization in the corpus region. Yet it has no influence on the acid-exposing status of gastric mucosa in patients with dyspepsia or chronic gastritis.