Influence of bile reflux, gastric acid and Helicobacter pylori infection on gastric mucosa injury

Objective To investigate the influence of bile reflux, gastric acid and Helicobacter pylori(Hp) infection on gastric mucosa. Methods A total of consecutive 30 patients who were with clinical bile reflux symptoms and confirmed with gastroendoscopy, performed the 24 hour bile and gastric pH monitoring tests simultaneously. Biopsy was performed under gastroendoscope from antrum lesser curture for Hp testing and mucosa pathoanalysis. According to New Sydney System, every mucosa was observed with Hp, active inflammation, atrophy, metaplasia, atypical hyperplasia. Symptom scores were calculated according to the extent of upper gastric pain, peritoneum dilation, bile vomiting, nausea, belching and anorexia. Time percentage of bilirubin absorbance was greater than 0.14 and time percentage of gastric pH lesser than 4. Simultaneous gastric bilirubin absorbance and pH value were obtained. Results Hp infecting rate was 23.3% in the 30 patients. Time percentage of gastric bile absorbance greater than 0.14 was ( 30.64± 14.67)%. Time percentage of gastric bile absorbance greater than 0.14 in Hp positive and negative group was ( 20.64± 7.13)% and ( 40.38± 13.35)% respectively(P 0.05). The erosion and metaplasia degree scores of antrum mucosa had positive correlation with the bile reflux degree(r=0 .749,P= 0.005). Conclusion Bile reflux inhibits the plantation of Hp in the stomach,and it is a risk for gastric mucosa injury.