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Effect of omeprazole on symptoms and ultrastructural esophageal damage in acid bile reflux

World Journal of Gastroenterology 2005年第12期11卷 1876-1880页

作者： Carlo Calabrese Anna Fabbri Mauro Bortolotti Giovanna Cenacchi Scialpi Carlo Desiree Zahlane Mario Miglioli Giulio Di Febo Dipartimento di Medicina Interna e Gastroenterologia

AIM: To value whether omeprazole could induce the healing of DIS and regression of symptoms in patients with DGER.METHODS: We enrolled 15 symptomatic patients with a pathological esophageal 24-h pH-metry and bilimetry.Patients underwent endoscopy and biopsies were taken from the distal esophagus. Specimens were analyzed at histology and transmission electron microscopy (TEM).Patients were treated with omeprazole 40 mg/d for 3 mo and then endoscopy with biopsies was repeated. Patients with persistent heartburn and/or with an incomplete recovery of DIS were treated for 3 more months and endoscopy with biopsies was performed.RESULTS: Nine patients had a non-erosive reflux disease at endoscopy (NERD) while 6 had erosive esophagitis (ERD). At histology, of the 6 patients with erosive esophagus,5 had mild esophagitis and 1 moderate esophagitis. No patients with NERD showed histological signs of esophagitis.After 3 mo of therapy, 13/15 patients (86.7%, P＜0.01)showed a complete recovery of DIS and disappearance of heartburn. Of the 2 patients treated for 3 more months,complete recovery of DIS and heartburn were achieved in one.CONCLUSION: Three or 6 mo of omeprazole therapy led to a complete regression of the ultrastructural esophageal damage in 86.7% and in 93% of patients with DGER, NERD and ERD respectively. The ultrastructural recovery of the epithelium was accompanied by regression of heartburn in all cases.

关键词：食道损伤胆汁逆流奥美拉唑药物治疗

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Effects of bile reflux on gastric mucosal lesions in patients with dyspepsia or chronic gastritis

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World Journal of Gastroenterology 2005年第18期11卷 2834-2837页

作者： Sheng-LiangChen Jian-ZhongMo Zhi-JunCao Xiao-YuChen Shu-DongXiao ShanghaiInstituteofDigestiveDisease RenjiHospitalShanghaiSecondMedicalUniversityShanghai200001China

AIM: To investigate the influences of bile reflux on profiles of gastric mucosal lesions in patients with dyspepsia or chronic gastritis.METHODS: A total of 49 patients diagnosed with dyspepsia and chronic gastritis underwent 24-h ambulatory andsimultaneous monitoring of intragastric bilirubin absorbance and pH values, and then they were divided into bile refluxpositive group and bile reflux negative group. Severity of pathological changes in gastric mucosa including activeinflammation, chronic inflammation, intestinal metaplasia, atrophy and dysplasia as well as Helicobacter pylori (H pylori) infection at the corpus, incisura and antrum were determined respectively according to update Sydney system criteria. The profiles of gastric mucosal lesions in the two groups were compared, and correlations between time-percentage of gastric bilirubin absorbance ＞0.14 and severity of gastric mucosal lesions as well as time-percentage of gastric pH ＞4 were analyzed respectively. RESULTS: Thirty-eight patients (21 men and 17 women, mean age 44.2 years, range 25-61 years) were found existing with bile reflux (gastric bilirubin absorbance ＞0.14) and 11 patients (7 men and 4 women, mean age 46.2 years,range 29-54 years) were bile reflux negative. In dyspepsia patients with bile reflux, the mucosal lesions such as active inflammation, chronic inflammation, intestinal metaplasia, atrophy or H pylori infection in the whole stomach, especially in the corpus and incisura, were significantly more severe than those in dyspepsia patients without bile reflux. Moreover, the bile reflux time was well correlated with the severity of pathological changes of gastric mucosa as well as H pylori colonization in the near-end stomach, especially in the corpus region. No relevance was found between the time of bile reflux and pH ＞4 in gastric cavity. CONCLUSION: Bile reflux contributes a lot to mucosal lesions in the whole stomach, may facilitate H pylori colonization in the corpus region, and has no influence on acid-exposing status of gastric mu

关键词：胆汁逆流胃损伤消化不良慢性胃炎病理机制

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24-hour Intraesophageal Simultaneous pH and Bile Monitoring in the Assessment of Reflux Esophagitis

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胃肠病学 2000年第B8期5卷 91-92页

作者： HuangXun ZhuHui-ming ZhanQun-shan Dept.ofGastroenterology ShenzhenPeople＇sHospitalShenzhen518020China Dept.ofGastroenterology ShenzhenPeople＇sHospitalShenzhen518020China

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Effect of Hydrotalcid and Cisapride on Bile Reflux Gastritis and Intragastric Bile

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胃肠病学 2000年第B8期5卷 157-157页

作者： ZhuAY XuGM LiZS ChanghaiHospital Shanghai200433China

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