duodenogastric reflux


Summary: Retrograde flow of duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the STOMACH.

Top Publications

  1. Sivarao D, Mashimo H, Goyal R. Pyloric sphincter dysfunction in nNOS-/- and W/Wv mutant mice: animal models of gastroparesis and duodenogastric reflux. Gastroenterology. 2008;135:1258-66 pubmed publisher
    ..In nNOS(-/-) mice, loss of nitrergic pyloric inhibition leads to gastric stasis and bezoars. In contrast, basal pyloric hypotension with normal nitrergic inhibition predisposes W/W(v) mice to duodenogastric bile reflux. ..
  2. Fountos A, Chrysos E, Tsiaoussis J, Karkavitsas N, Zoras O, Katsamouris A, et al. Duodenogastric reflux after biliary surgery: scintigraphic quantification and improvement with erythromycin. ANZ J Surg. 2003;73:400-3 pubmed
    ..There is -evidence that at least some of these symptoms may be attributed to duodenogastric reflux (DGR)...
  3. Sato T, Miwa K, Sahara H, Segawa M, Hattori T. The sequential model of Barrett's esophagus and adenocarcinoma induced by duodeno-esophageal reflux without exogenous carcinogens. Anticancer Res. 2002;22:39-44 pubmed
    ..The temporal progression from Barrett's esophagus to columnar dysplasia and adenocarcinoma is induced by duodeno-esophageal reflux. Columnar dysplasia is a morphological marker for adenocarcinogenesis. ..
  4. Bollschweiler E, Wolfgarten E, Pütz B, Gutschow C, Holscher A. Bile reflux into the stomach and the esophagus for volunteers older than 40 years. Digestion. 2005;71:65-71 pubmed
    ..The volunteers serving as controls in those studies were significantly younger than the patients. The aim of this study was to analyze bile reflux patterns of healthy volunteers aged comparably to patients with Barrett's esophagus...
  5. Hermans D, Sokal E, Collard J, Romagnoli R, Buts J. Primary duodenogastric reflux in children and adolescents. Eur J Pediatr. 2003;162:598-602 pubmed
    Primary duodenogastric reflux is a rare disorder in adults which has not yet been documented in children. Six young patients, aged 4.5 to 16.5 years (median 13...
  6. Bowrey D, Williams G, Carey P, Clark G. Inflammation at the cardio-oesophageal junction: relationship to acid and bile exposure. Eur J Gastroenterol Hepatol. 2003;15:49-54 pubmed
    ..of carditis with oesophageal acid exposure (gastro-oesophageal reflux) and proximal gastric bile exposure (duodenogastric reflux) in patients with symptoms of gastro-oesophageal reflux disease (GORD)...
  7. Liron R, Parrilla P, Martinez de Haro L, Ortiz A, Robles R, Lujan J, et al. Quantification of duodenogastric reflux in Barrett's esophagus. Am J Gastroenterol. 1997;92:32-6 pubmed
    ..Therefore, we performed a study to quantify duodenogastric reflux, using 99mTc-HIDA quantification in gastric juice after continuous intravenous infusion of the same...
  8. Tibbling Grahn L, Blackadder L, Franzen T, Kullman E. Gastric bile monitoring: an in vivo and in vitro study of Bilitec reliability. Scand J Gastroenterol. 2002;37:1334-7 pubmed
    ..The aim was to study the reliability of the Bilitec 2001 method inmonitoring the presence of bile in repeated tests and at different pH and water dilutions...
  9. Jang T, Min S, Bae J, Jung K, Lee J, Kim J, et al. Expression of cyclooxygenase 2, microsomal prostaglandin E synthase 1, and EP receptors is increased in rat oesophageal squamous cell dysplasia and Barrett's metaplasia induced by duodenal contents reflux. Gut. 2004;53:27-33 pubmed
    ..We suggest that the biosynthetic pathway of PGE2 may play an important role in oesophageal squamous cell dysplasia and glandular metaplasia induced by duodenal contents reflux. ..

More Information


  1. Santarelli L, Gabrielli M, Candelli M, Cremonini F, Nista E, Cammarota G, et al. Post-cholecystectomy alkaline reactive gastritis: a randomized trial comparing sucralfate versus rabeprazole or no treatment. Eur J Gastroenterol Hepatol. 2003;15:975-9 pubmed
    ..Both sucralfate and rabeprazole therapies are effective treatment options in the patients with alkaline gastritis when compared with observation. ..
  2. Tritapepe R, Piro D, Damilano I. Long-term effects in bilio-digestive shunts. Ital J Gastroenterol. 1993;25:425-8 pubmed
    b>Duodenogastric reflux (DGR) and its effects were studied in patients with bile stones, operated by various bilio-digestive by-pass techniques, and followed up for 13-73 months...
  3. Marshall R, Anggiansah A, Owen W, Manifold D, Owen W. The extent of duodenogastric reflux in gastro-oesophageal reflux disease. Eur J Gastroenterol Hepatol. 2001;13:5-10 pubmed
    ..It is unclear whether this is accompanied by increasing duodenogastric reflux (DGR)...
  4. Brillantino A, Monaco L, Schettino M, Torelli F, Izzo G, Cosenza A, et al. Prevalence of pathological duodenogastric reflux and the relationship between duodenogastric and duodenogastrooesophageal reflux in chronic gastrooesophageal reflux disease. Eur J Gastroenterol Hepatol. 2008;20:1136-43 pubmed publisher
    The role of duodenogastric reflux in gastrooesophageal reflux disease is still controversial...
  5. Fukuhara K, Osugi H, Takada N, Takemura M, Lee S, Taguchi S, et al. Duodenogastric reflux eradicates Helicobacter pylori after distal gastrectomy. Hepatogastroenterology. 2004;51:1548-50 pubmed
    Patients who undergo distal gastrectomy often develop duodenogastric reflux and preoperative H. pylori infection is eradicated spontaneously after distal gastrectomy in some patients...
  6. Stein H, Smyrk T, Demeester T, Rouse J, Hinder R. Clinical value of endoscopy and histology in the diagnosis of duodenogastric reflux disease. Surgery. 1992;112:796-803; discussion 803-4 pubmed
    ..finding of foveolar hyperplasia or chronic gastritis have been implicated as indicators of excessive duodenogastric reflux. The accuracy of these criteria was evaluated in 135 patients with nonspecific symptoms in the foregut ..
  7. Zhang F, Altorki N, Wu Y, Soslow R, Subbaramaiah K, Dannenberg A. Duodenal reflux induces cyclooxygenase-2 in the esophageal mucosa of rats: evidence for involvement of bile acids. Gastroenterology. 2001;121:1391-9 pubmed
    ..Reflux of duodenal contents into the esophagus led to increased COX-2 expression and mucosal thickening. Bile acids are likely to contribute to these effects. ..
  8. Miwa K, Segawa M, Takano Y, Matsumoto H, Sahara H, Yagi M, et al. Induction of oesophageal and forestomach carcinomas in rats by reflux of duodenal contents. Br J Cancer. 1994;70:185-9 pubmed
    ..These findings indicate that chronic reflux of duodenal contents may cause oesophageal carcinoma. ..
  9. Fein M, Fuchs K, Stopper H, Diem S, Herderich M. Duodenogastric reflux and foregut carcinogenesis: analysis of duodenal juice in a rodent model of cancer. Carcinogenesis. 2000;21:2079-84 pubmed
    ..Chronic inflammation is likely to be the mechanism of carcinogenesis by duodenogastric reflux.
  10. Vaezi M, Richter J. Duodenogastroesophageal reflux and methods to monitor nonacidic reflux. Am J Med. 2001;111 Suppl 8A:160S-168S pubmed
    ..Studies show that this may be accomplished by antireflux surgery or the use of proton pump inhibitors, which by reducing gastric volume, decrease the damaging potential of both acid and DGER...
  11. Koek G, Vos R, Sifrim D, Cuomo R, Janssens J, Tack J. Mechanisms underlying duodeno-gastric reflux in man. Neurogastroenterol Motil. 2005;17:191-9 pubmed
    ..In healthy subjects, duodenogastric reflux occurs sporadically in the interdigestive state and is a normal phenomenon in the postprandial period...
  12. Tack J, Bisschops R, Koek G, Sifrim D, Lerut T, Janssens J. Dietary restrictions during ambulatory monitoring of duodenogastroesophageal reflux. Dig Dis Sci. 2003;48:1213-20 pubmed
    ..Thus, ambulatory Bilitec monitoring requires the use of liquid meals, as the use of solid meals is associated with too many meal artifacts and a poorer correlation with acid reflux and severity of endoscopic lesions. ..
  13. Kondo K. Duodenogastric reflux and gastric stump carcinoma. Gastric Cancer. 2002;5:16-22 pubmed
    ..The stump carcinoma was often found to be localized to the anastomosis, known to be the site with severe duodenogastric reflux. For this reason, duodenogastric reflux, including the reflux of bile and pancreatic juice, after a ..
  14. Katsoulis I, Robotis I, Kouraklis G, Yannopoulos P. Duodenogastric reflux after esophagectomy and gastric pull-up: the effect of the route of reconstruction. World J Surg. 2005;29:174-81 pubmed
    b>Duodenogastric reflux (DGR) is a common sequel of subtotal esophagectomy and gastric pull-up, and it may contribute to mucosal changes of both the gastric conduit and the esophageal remnant...
  15. Wilson P, Jamieson J, Hinder R, Anselmino M, Perdikis G, Ueda R, et al. Pathologic duodenogastric reflux associated with persistence of symptoms after cholecystectomy. Surgery. 1995;117:421-8 pubmed
    The aim of this study was to determine whether increased duodenogastric reflux contributes to postcholecystectomy symptoms...
  16. Piotrowski W, Chojnacki J, Gil J, Walecka Kapica E. [The influence of Helicobacter pylori eradication on oesophageal pH-metry and bilimetry results in patients with nonulcer dyspepsia]. Pol Merkur Lekarski. 2004;17 Suppl 1:136-8 pubmed
    ..They are expressed as duodenogastroesophageal reflux. The refluxes intensity depends on the extent of Helicobacter pylori infection, which should be remembered when planning antibacterial treatment. ..
  17. Lychkova A. Role of serotoninergic system in the development of gastrointestinal diseases. Bull Exp Biol Med. 2009;147:262-8 pubmed
    ..Activation of the serotoninergic system promoted the development of alteration processes in gastroduodenal ulcer. ..
  18. Stein H, Hinder R, Demeester T, Lloyd B, Fuchs K, Attwood S, et al. Clinical use of 24-hour gastric pH monitoring vs o-diisopropyl iminodiacetic acid (DISIDA) scanning in the diagnosis of pathologic duodenogastric reflux. Arch Surg. 1990;125:966-70; discussion 970-1 pubmed
    ..was compared with that of computerized analysis of 24-hour gastric pH monitoring to diagnose excessive duodenogastric reflux in 22 normal volunteers and 106 consecutive patients with foregut symptoms...
  19. Cheng P, Li J, Gong J, Zhang L, Chen R. Effects of refluxate pH values on duodenogastroesophageal reflux-induced esophageal adenocarcinoma. World J Gastroenterol. 2011;17:3060-5 pubmed publisher
    ..The non-acid reflux is particularly important in the progression from BE to cancer. Therefore, control of duodenal reflux may be an important prophylaxis for EAC. ..
  20. Taşkin V, Sedele M, Saka O, Kantarceken B. The effect of duodenogastric reflux on Helicobacter pylori presence and gastric histopathologic changes. Turk J Gastroenterol. 2003;14:239-42 pubmed
    ..of Helicobacter pylori infection and gastric histological changes in unoperated patients with and without duodenogastric reflux. Twenty-two women and 15 men, mean age of 51...
  21. Fukuhara K, Osugi H, Takada N, Takemura M, Higashino M, Kinoshita H. Reconstructive procedure after distal gastrectomy for gastric cancer that best prevents duodenogastroesophageal reflux. World J Surg. 2002;26:1452-7 pubmed
    ..Roux-Y reconstruction is superior to either Billroth I or II reconstruction for preventing bile reflux into the gastric remnant and esophagus after distal gastrectomy. ..
  22. Eren M, Temizel I. Duodenogastric reflux and Helicobacter pylori infection in children. Am J Gastroenterol. 2003;98:1443-4 pubmed
  23. Elgazzar A, Fernandez Ulloa M, Ryan J, McDevitt R, Daya S, Maxon H. Scintigraphic evaluation of duodenogastric reflux: significance in the diagnosis of acute cholecystitis. Am J Physiol Imaging. 1992;7:239-41 pubmed
    b>Duodenogastric reflux (DGR) as seen on hepatobiliary scintigraphy has been reported as a useful secondary sign for the diagnosis of acute cholecystitis...
  24. Quigley E. Critical care dysmotility: abnormal foregut motor function in the ICU/ITU patient. Gut. 2005;54:1351-2; discussion 1384-90 pubmed
  25. Oba M, Miwa K, Fujimura T, Harada S, Sasaki S, Oyama K, et al. A selective cyclooxygenase-2 inhibitor prevents inflammation-related squamous cell carcinogenesis of the forestomach via duodenogastric reflux in rats. Cancer. 2009;115:454-64 pubmed publisher
    ..A series of 188 rats underwent a surgical duodenogastric reflux procedure and were divided into 2 groups...
  26. Hoya Y, Mitsumori N, Yanaga K. The advantages and disadvantages of a Roux-en-Y reconstruction after a distal gastrectomy for gastric cancer. Surg Today. 2009;39:647-51 pubmed publisher
    ..However, a Roux-en-Y reconstruction is increasingly performed to prevent duodenogastric reflux. We herein discuss the indications for Roux-en-Y in gastric surgery and review the literature to determine ..
  27. Fuchs K, Demeester T, Hinder R, Stein H, Barlow A, Gupta N. Computerized identification of pathologic duodenogastric reflux using 24-hour gastric pH monitoring. Ann Surg. 1991;213:13-20 pubmed
    b>Duodenogastric reflux is a naturally occurring sporadic event, the incidence, occurrence, and detrimental effects of which have been difficult to assess...
  28. Del Genio G, Rossetti G, Brusciano L, Russo G, Russo F, Francesco P, et al. Laparoscopic duodenal switch for pathologic duodenogastric reflux: initial experience. Surg Laparosc Endosc Percutan Tech. 2007;17:517-20 pubmed
    b>Duodenogastric reflux (DGR) is barely responsive to medications and antireflux fundoplication is not able to control the gastric symptoms...
  29. Nasr A, Dillon M, Conlon S, Downey P, Chen G, Ireland A, et al. Acid suppression increases rates of Barrett's esophagus and esophageal injury in the presence of duodenal reflux. Surgery. 2012;151:382-90 pubmed publisher
    ..PPIs suppressed acute inflammatory changes only, whereas chronic inflammatory changes persisted. ..
  30. Nogi K, Haruma K, Taniguchi H, Yomota E, Okajima M, Hananoki M, et al. Duodenogastric reflux following cholecystectomy in the dog: role of antroduodenal motor function. Aliment Pharmacol Ther. 2001;15:1233-8 pubmed
    b>Duodenogastric reflux has been implicated in the pathogenesis of gastric ulcer and gastritis. Duodenogastric reflux after cholecystectomy is also a possible cause of post-cholecystectomy syndrome...
  31. Stavraka A, Madan A, Frantzides C, Apostolopoulos D, Vlontzou E. Gastric emptying time, not enterogastric reflux, is related to symptoms after upper gastrointestinal/biliary surgery. Am J Surg. 2002;184:596-9; discussion 599-600 pubmed
    ..Delayed gastric emptying time, not frequency or extent of EGR, was associated with the symptoms of bile reflux in patients who had previous upper gastrointestinal or biliary operations. ..
  32. Shi S, Klotz U. Proton pump inhibitors: an update of their clinical use and pharmacokinetics. Eur J Clin Pharmacol. 2008;64:935-51 pubmed publisher
  33. Morais E, Andrade J, Hsien C, Barbieri Neto J, Vicente W, Ceneviva R. The effect of proximal gastric vagotomy plus duodenoplasty on duodenogastric reflux. Am Surg. 1992;58:647-50 pubmed
    ..In this study, the amount of duodenogastric reflux was assessed in patients who previously underwent proximal gastric vagotomy (PGV group; n = 11) and PGV ..
  34. Nakagawara H, Miwa K, Nakamura S, Hattori T. Duodenogastric reflux sustains Helicobacter pylori infection in the gastric stump. Scand J Gastroenterol. 2003;38:931-7 pubmed
    b>Duodenogastric reflux (DGR) and Helicobacter pylori infection have been suspected of being contributing agents to the genesis of gastritis and subsequent cancer, but compelling, conclusive data about the exact relationship have been ..
  35. Demeester T, Fuchs K, Ball C, Albertucci M, Smyrk T, Marcus J. Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux. Ann Surg. 1987;206:414-26 pubmed
    Existing Roux-en-Y bile diversion procedures for duodenogastric reflux coupled with distal gastric resection or antrectomy and vagotomy have varied success due to interruption of the physiologic relationships between stomach and duodenum,..
  36. Dutra R, Araújo W, Andrade J. The effects of Roux-en-Y limb length on gastric emptying and enterogastric reflux in rats. Acta Cir Bras. 2008;23:179-83 pubmed
    ..A standard Roux limb, besides being unable to protect the stomach from the enterogastric reflux, may become a functional barrier for gastric emptying. ..
  37. da Rocha J, Ribeiro U, Sallum R, Szachnowicz S, Cecconello I. Barrett's esophagus (BE) and carcinoma in the esophageal stump (ES) after esophagectomy with gastric pull-up in achalasia patients: a study based on 10 years follow-up. Ann Surg Oncol. 2008;15:2903-9 pubmed publisher
    ..2) These mucosal alterations and the development of squamous cell carcinoma and adenocarcinoma are probably due to exposure to duodenogastric reflux, and progressively higher acid output in the transposed stomach.
  38. Terasaki M, Totsuka Y, Nishimura K, Mukaisho K, Chen K, Hattori T, et al. Detection of endogenous DNA adducts, O-carboxymethyl-2'-deoxyguanosine and 3-ethanesulfonic acid-2'-deoxycytidine, in the rat stomach after duodenal reflux. Cancer Sci. 2008;99:1741-6 pubmed publisher
  39. Xynos E, Vassilakis J, Fountos A, Pechlivanides G, Karkavitsas N. Enterogastric reflux after various types of antiulcer gastric surgery: quantitation by 99mTc-HIDA scintigraphy. Gastroenterology. 1991;101:991-8 pubmed
    ..Sixteen of these patients underwent Roux-en-Y gastrectomy and their preoperative symptoms were relieved. ..
  40. Charitopoulos N, Karkanias G, Dimitraki T, Papadimitriou C, Golematis B. Postoperative alkaline reflux gastritis following vagotomy. Hepatogastroenterology. 1994;41:542-5 pubmed
    ..Helicobacter pylori was found more frequently in biopsy specimens from patients with severe symptoms (30.3%), but was present in only 14.6% of the total number of the patients with postoperative alkaline reflux gastritis after vagotomy. ..
  41. Hirano I. Review article: modern technology in the diagnosis of gastro-oesophageal reflux disease--Bilitec, intraluminal impedance and Bravo capsule pH monitoring. Aliment Pharmacol Ther. 2006;23 Suppl 1:12-24 pubmed
    ..All three diagnostic modalities have advanced the understanding of GERD pathogenesis, but their impact on the clinical management of GERD is still the focus of active investigation. ..
  42. Miwa K, Miyashita T, Hattori T. [Reflux of duodenal or gastroduodenal contents induces esophageal carcinoma in rats]. Nihon Rinsho. 2004;62:1433-8 pubmed
    ..Chronic duodenal reflux induces the development of esophageal carcinoma not only adenocarcinoma also squamous cell carcinoma and adenosquamous carcinoma. These pathways of carcinogenesis were different dual patterns. ..
  43. Vdovychenko A. Is a bile reflux an additional cancerogenic factor in peptic ulcer, associated with Helicobacter pylori infection?. Rocz Akad Med Bialymst. 2004;49:72-4 pubmed
    ..is still unknown, it was the aim of our investigations in peptic ulcer (PU) patients complicated with duodenogastric reflux (DGR). 79 PU patients (49 men, 27 women, aged 18 to 61, middle age--41...
  44. Lehrer J, Katz P. Is duodenogastroesophageal reflux impliated in Barrett's esophagus?. Am J Gastroenterol. 2002;97:2463-4 pubmed
  45. Kaminishi M. How is it possible to prevent gastric mucosal injury and remnant cancer after distal gastrectomy?. J Gastroenterol. 2005;40:661-3 pubmed
  46. Fein M, Fuchs K, Freys S, Maroske J, Tigges H, Thiede A. [Is duodeno-gastro-esophageal reflux just a bystander of acid reflux?]. Zentralbl Chir. 2002;127:1068-72 pubmed
    ..Normal values: DGER - Exposure time esophagus > 11.8 % using an absorbance value > 0.14, duodenogastric reflux (DGR) - Exposure time stomach >24.8 % using an absorbance value > 0.25...
  47. Lee S, Osugi H, Tokuhara T, Kaseno S, Takada N, Takemura M, et al. Self-expandable metallic stents with an anti-reflux mechanism for malignant strictures of gastroesophageal junction. Scand J Gastroenterol. 2002;37:990-1 pubmed
  48. Kinoshita Y, Kazumori H, Ishihara S. Treatment of proton pump inhibitor-resistant patients with gastroesophageal reflux disease. J Gastroenterol. 2006;41:286-7 pubmed
  49. Oyama K, Fujimura T, Ninomiya I, Miyashita T, Kinami S, Fushida S, et al. [Cyclooxygenase (COX)-2 expression in a rat duodenoesophageal reflux model and chemoprevention of adenocarcinoma by the selective COX-2 inhibitor nimesulide]. Nihon Shokakibyo Gakkai Zasshi. 2007;104:1183-91 pubmed
    ..COX-2 may play an important role in esophageal carcinogenesis through the activation of the inflammation-metaplasia-adenocarcinoma sequence. Nimesulide is effective in preventing BE and EAC by suppressing COX-2 activity. ..
  50. Romanowski M, Chojnacki J, Gil J, Piotrowski W. [Assessment of duodenogastric reflux 24h variability in subjects with functional dyspepsia]. Pol Merkur Lekarski. 2004;17 Suppl 1:125-7 pubmed
    ..The aim of the study was to find out whether duodenogastric reflux is observed in subjects with nonulcer (NUD) and dysmotor dyspepsia (DD) and whether its intensification ..
  51. Kunsch S, Neesse A, Huth J, Steinkamp M, Klaus J, Adler G, et al. Increased Duodeno-Gastro-Esophageal Reflux (DGER) in symptomatic GERD patients with a history of cholecystectomy. Z Gastroenterol. 2009;47:744-8 pubmed publisher
    ..Both the frequency and the extent of DGER was significantly increased in the CCE-group. Prospective studies are urgently needed to elucidate the impact of CCE on DGER in patients with clinical symptoms of a reflux disease. ..
  52. Galli J, Cammarota G, Calo L, Agostino S, D Ugo D, Cianci R, et al. The role of acid and alkaline reflux in laryngeal squamous cell carcinoma. Laryngoscope. 2002;112:1861-5 pubmed
    ..In last years, great interest has been focused on gastroesophageal reflux as independent carcinogenic factor and co-carcinogen in association with smoking and alcohol assumption...
  53. Shimotakahara A, Yamataka A, Yanai T, Kobayashi H, Okazaki T, Lane G, et al. Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy for biliary reconstruction during the surgical treatment of choledochal cyst: which is better?. Pediatr Surg Int. 2005;21:5-7 pubmed
    ..3%) of complications due to duodenogastric bile reflux. Currently, RYHJ is our exclusive technique of choice for biliary reconstruction during the surgical repair of CC...