Duodenogastric reflux: Proposed new endoscopic classification in symptomatic patients

Abstract

Background: Duodenal contents reflux through the pylorus into the stomach can cause chronic gastritis and gastric cancer. This study aims to propose a new classification of endoscopic findings of duodenogastric reflux (DGR) in symptomatic patients. Patients and Methods: Eighty-eight patients with symptoms of DGR were included. Endoscopic findings, Helicobacter pylori, and mucosa pathological were recorded. Hepatobiliary scintigraphy was performed to quantify the DGR. Results: Among the 88 patients, 41 patients had normal mucosa (control group), 36 patients had bile lake (BL) (Group A), and 11 patients had bile stain (BS) (Group B). Group A significantly increases in postprandial DGR at 50 and 60 min. Group B significantly increases in fasting DGR at 50 and 60 min and postprandial DGR at 30, 40, 50, and 60 min. Group A and Group B had significant high intestine metaplasia and mucosal inflammation score than those in control group. Group B had a significantly higher incidence of gastric polyp than those patients in Group A and control group. Conclusions: Endoscopic findings of BS increased both fasting and postprandial DGR. BL had significant increased postprandial DGR. DGR increased the intestine metaplasia, mucosal inflammation, and gastric polyp in the stomach.