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New Causes for the Old Problem of Bile Reflux Gastritis

  • Marshall E. McCabe IV
    Affiliations
    Indiana University School of Medicine, Indianapolis, Indiana
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  • Christen K. Dilly
    Correspondence
    Reprint requests Address requests for reprints to: Christen K. Dilly, MD, MEHP, Indiana University School of Medicine, Division of Gastroenterology, Hepatology and Nutrition, 702 Rotary Circle, Suite 225, Indianapolis, Indiana 46202; fax: (317) 278-6870.
    Affiliations
    Indiana University School of Medicine, Indianapolis, Indiana

    Roudebush VA Medical Center, Indianapolis, Indiana
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Published:March 02, 2018DOI:https://doi.org/10.1016/j.cgh.2018.02.034
      Bile reflux gastritis (also known as “duodenogastric reflux,” “biliary gastritis,” or “alkaline reflux gastritis”) occurs when there is retrograde movement of bile into the stomach, leading to clinical symptoms, endoscopic changes, and histologic features of a chemical (reactive) gastritis. Although William Beaumont first observed bile reflux in a patient with a gastrocutaneous fistula in 1833,

      Beaumont W. Experiments and observations on the gastric juice, and the physiology of digestion. Plattsburgh: Printed by F. P. Allen, 1833.

      it was not until gastric surgery became routine in the late 1800s that the clinical importance of this problem was recognized. For nearly a century, this was thought to be a surgical disease, caused by resection or alteration of the pylorus. However, bile reflux gastritis is increasingly found in individuals without prior gastric surgery, a problem termed “primary biliary reflux.” Both surgical and pharmacologic interventions are used to treat this challenging condition.

      Abbreviation used in this paper:

      UDCA (ursodeoxycholic acid)
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      References

      1. Beaumont W. Experiments and observations on the gastric juice, and the physiology of digestion. Plattsburgh: Printed by F. P. Allen, 1833.

        • Testoni P.A.
        • Fanti L.
        • Passaretti S.
        • et al.
        Interdigestive motility pattern in subjects with duodenogastric bile reflux.
        Scand J Gastroenterol. 1987; 22: 757-762
        • Atak I.
        • Ozdil K.
        • Yucel M.
        • et al.
        The effect of laparoscopic cholecystectomy on the development of alkaline reflux gastritis and intestinal metaplasia.
        Hepatogastroenterology. 2012; 59: 59-61
        • Vere C.C.
        • Cazacu S.
        • Comanescu V.
        • et al.
        Endoscopical and histological features in bile reflux gastritis.
        Rom J Morphol Embryol. 2005; 46: 269-274
        • Ritchie W.P.
        Alkaline reflux gastritis: a critical reappraisal.
        Gut. 1984; 25: 975-987
        • Madura J.A.
        Primary bile reflux gastritis: diagnosis and surgical treatment.
        Am J Surg. 2003; 186: 269-273
        • Niemela S.
        Duodenogastric reflux in patients with upper abdominal complaints or gastric ulcer with particular reference to reflux-associated gastritis.
        Scand J Gastroenterol Suppl. 1985; 115: 1-56
        • Beaumont W.
        • Osler W.
        Experiments and observations on the gastric juice and the physiology of digestion / William Beaumont. Together with a biographical essay, William Beaumont: a pioneer American physiologist / by Sir William Osler.
        Dover, Mineola, N.Y1996
        • Dixon MFOcH.
        • Axon A.T.R.
        • King R.F.J.G.
        • et al.
        Reflux gastritis: distinct histopathological entity?.
        J Clin Pathol. 1986; 39: 524-530
        • Santarelli L.
        • Gabrielli M.
        • Candelli M.
        • et al.
        Post-cholecystectomy alkaline reactive gastritis: a randomized trial comparing sucralfate versus rabeprazole or no treatment.
        Eur J Gastroenterol Hepatol. 2003; 15: 975-979
        • Stefaniwsky A.B.
        • Tint G.S.
        • Speck J.
        • et al.
        Ursodeoxycholic acid treatment of bile reflux gastritis.
        Gastroenterology. 1985; 89: 1000-1004