Clinical Analysis Of 136 Cases Of Bile Reflux Gastritis

BACKGROUND AND AIM Bile reflux gastritis is one of the common diseases of gastroenterology, but its etiological factors and etiopathogenisis remain unclear and there is still a lack of definite diagnostic criteria for it. The current therapeutic strategy is to bind bile to reduce the damage of refluxing contents, and to improve gastrointestinal dynamia and promote coordinated duodenogastric motility to reduce the occurrence of duodenogastric reflux. This paper is to explore the clinical characteristics of the patients with bile reflux gastritis in our hospital.MATERIALS AND METHODS 136 patients were diagnosed with bile reflux gastritis during the period of September to December of 2006 in the First Affiliated Hospital of Zhejiang University Medical School, and recruited in the study. The clinical data, including a questionnaire investigation, of these patients were reviewed and analyzed retrospectively. And it is intended to discuss its etiological factor, etiopathogenisis, clinical characteristic, diagnose and therapy further.RESULTS Among the 136 patients, 40 (29.4%) had gallbladder diseases, of which 38 had cholecystitis or gallstone and 2 cholecyst polypi, and 20 of them underwent a cholecystectomy previously; 32 (23.5%) patients underwent a previous subtotal gastrectomy, including 7 cases of Billroth I and 25 cases of Billroth II; 64 (47.1%) had no obvious etiological factors, including 39 patients who had psychological problems or a stringent state such as stressfulness, anxiousness, and depression. All of the patients had symptoms of dyspepsia. Endoscopically, observed were the gastric mucosa sticking to the bile patch, congestion, and edema, and bile reflux from the pylorus as well, of which the pathologic results were all chronic mucosal inflammation. After the therapy of hydrotalcite and mosapride or domperidone, the symptoms of 130 (95.6%) patients had been relieved.CONCLUSIONS1. Biliary diseases (cholecystitis, cholelithiasis and postcholecystectomy) and subtotal gastrectomy are important etiological factors of bile reflux gastritis; psychological factors may also play a role in the occurrence of bile reflux gastritis.2. The clinical manifestation of bile reflux gastritis is similar to the one of general chronic gastritis, and its clinic diagnosis depends on endoscopical observation and pathological examination.3. H. pylori infection rate of blie reflux gastritis is cut down.4. The combined application of cholalic acid and promotility agents to treat bile reflux gastritis may obtain a better curative effect.