Influence of bile reflux on gastric mucosa in children

The bile reflux, which is the refraction of duodenal contents to the stomach, is a common phenomenon observed during the endoscopy of the upper part of gastrointestinal tract. Although numerous reports emphasise the destructive influence of bile components upon gastric mucosa, some authors are doubtful about this fact. Almost all the studies are concerned exclusively with adults. Therefore, the aim of the present investigation was to evaluate the endoscopic and morphologic changes in children with bile reflux. We examined 1120 children with abdominal pain. In 92 cases (8.21%) the endoscopic examination revealed the bile reflux. In order to verify these results, the cholescintigraphy (Tc99-HEPIDA) was performed. The method confirmed the presence of pathologic changes in 59 cases (64.1%), while 33 results (35.9%) were found false positive. We could not detect any correlation between the scintigraphic picture of marker distribution within stomach and the intensity of morphologic changes. This might have resulted from the fact that milk was used as a test meal, therefore the change in methodology would be advisable. Furthermore, there was no correlation between the reflux index and the intensity of inflammatory changes in gastric and duodenal mucosa. Instead, it was found that children with bile reflux are less frequently infected with Helicobacter pylori.
key words: bile reflux, gastritis biliaris, cholescintigraphy, Helicobacter pylori

Keywords: Bile Reflux, gastritis biliaris, cholescintigraphy, Helicobacter pylori