Objective: To study the diadynamic method of primary bile reflux gastritis.
Methods: Endoscopy, histologic examination, symptom analysis and 24-hour gastritic bilirubin monitoring with Bilitec 2000 were performed in 20 healthy subjects (HS) and 42 patients with symptoms of abdominal pain, abdominal distention, nausea and bile vomiting.
Results: The total fraction time of bile reflux was higher in 42 patents than in 20 HS [(17.68 +/- 17.89)% vs. (2.92 +/- 2.39)%, P < 0.01]. 23 (55%) of 42 patients showed pathologic duodenogastric reflux (DGR). The incidence of pathologic DGR detected by Bilitec2000 in bile dyed mucous lake, antral mucosal erosion, bile dyed mucous lake accompanied with erosion and bile dyed mucous lake accompanied with middle-hyperemia of antral mucosae found in endoscopy were 86%, 88%, 8/8 and 85% respectively. The diagnosis of bile reflux gastritis (BRG) could be established if the patients with bile dyed mucous lake accompanied with erosion and/or middle-hyperemia of antral mucosae were found to be pathologic DGR. With this criterion, 11 patients were BRG in 42 patients in this study. The active inflammation of antral mucosae in the patients with BRG that without Helicobacter pylori (Hp) infection was more severe than that in the patients with physiologic DGR that without Hp infection significantly (P < 0.05). The symptoms of abdominal distention, nausea and bile vomiting in the patients with BRG were more severe significantly than those in the patients with physiologic DGR respectively (P < 0.05).
Conclusions: Final diagnosis of BRG can be made for the integrity stomach if the patients with bile dyed mucous lake accompanied with erosion and/or middle-hyperemia of antral mucosae were found to be pathologic DGR by Bilitec 2000.