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[Prevalence of a pathological DGER (duodeno-gastric-oesophageal reflux) in patients with clinical symptoms of reflux disease].

BACKGROUND: According to recent studies DGER (duodeno-gastric-oesophageal reflux) is considered as an independent risk factor for the development of reflux esophagitis and the Barrett metaplasia. The Bilitec 2000 allows a qualitative and quantitative measurement of DGER in patients with symptoms of reflux disease. The aim of the present study was to investigate the prevalence of DGER in patients with reflux symptoms.

METHODS: 146 patients with symptoms of gastro-oesophageal reflux disease were enrolled in this study. Patients underwent upper gastrointestinal endoscopy, oesophageal manometry and simultaneous 24 h oesophageal pH and bilirubin monitoring. The presence of pathological DGER and its relations to the symptom pattern, distal oesophageal acid exposure and endoscopic findings were analysed.

RESULTS: In 74 out of 146 patients (51 %, 39 men, 34 women) a DGER could be detected. Twenty-eight (32 %) of these patients suffered from an isolated DGER, while 46 (32 %) had a combined acid and DGER reflux. An isolated acid reflux was found in additional 28 (19 %) patients. The degrees of both acid and DGER were significantly higher in those patients with oesophageal lesions.

CONCLUSIONS: 1. There is a high prevalence of DGER in patients with the clinical symptoms of a reflux disease. 2. The combined measurement of acid reflux and DGER helps to better define the cause of reflux symptoms. 3. In analogy to the acid reflux DGER increases with the gravity of oesophageal lesions.

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