전형적인 위식도역류 증상을 가진 환자에서 십이지장위식도역류와 위배출능과의 상관관계 = The Correlation between Duodenogastroesophageal Reflux and Gastric Emptying in Patients with Typical Symptoms of Gastroesophageal Reflux

다국어 초록 (Multilingual Abstract)

Background/Aims: Duodenogastroesophageal reflux (DGER) has been reported to occur in gastroesopahgeal retlux disease (GERD) and has been known to have a synergistic role in the development of esophageal mucosal injury. There is controversy on the role of delayed gastric emptying in the pathophysiology of GERD. The aim of this study is to evaluate the correlation between DGER and gastric emptying (total and proximal) in patients with typical symptoms of gastroesophageal reflux (GER). Methods: Simultaneous monitoring of ambulatory 24-hr esophageal pH and biIirubin (using Bilitec 2000) and esophagogastroduodenoscopy were done in 38 patients with typical symptoms of GER (19 male, mean age: 44.1 years). Gastric emptying scan was performed using 99mTc-DTPA labelled solid meal in the above patient group and 10 healthy controls (6 male, mean age: 32.5 years), and then total gastric emptying time (T1/2) and proximal gastric emptying time (PT1/2) were measured. Results: 1) Abnormal acid reflux without abnormal bile reflux was diagnosed in 8 (21.1%) of 38 patients (Group I). Abnormal bile reflux was diagnosed in 10 (26.3%) of 38 patients (Group II). There was neither acid nor bile reflux in 20 (52.6%) of 38 patients (Group III). 2) Total gastric emptying time (T1/2) was not significantly different between controls and each groups. 3) Proximal gastric emptying time (PT1/2) was significantly delayed in Group II (94.2+-37.6 min) when compared with controls (59.9.+-24.2 min)(p<0.05). Conclusions: Delayed proximal gastric emptying could be a contributing factor in the pathophysiology of duodenogastroesophageal reflux in gastroesophageal reflux disease. (Korean J Gastroenterol 1998;31:153 - 159)