Abstract
In this study we compared the results of measurement of duodenogastric reflux using 24-hour intragastric pH monitoring and nasogastric aspiration with analysis of bile acid and alpha amylase concentrations. Eight patients were studied at least 5 months after biliary and/or gastric surgery. The correlation coefficient of pH and bile acid concentration was 0.36 (p<0.001) and of pH and amylase concentration was 0.48 (p<0.001). If a pH > 4.0 was taken to indicate duodenogastric reflux this had a sensitivity of 84% compared with either high bile acid or amylase concentration. Bile acid concentration has been the “standard” method of measuring duodenogastric reflux. pH monitoring is relatively simple to perform, causes little patient distress, and can measure episodes of duodenogastric reflux over a continuous 24-hour period.
Résumé
Dans cette étude, on a comparé la quantification du reflux duodénogastrique par la mesure du pH intragastrique des 24 heures, par l'aspiration naso-gastrique, par l'analyse de la bile et par l'amylasémie. Huit patients ont été étudier au moins cinq mois après la chirurgie gastrique et/ou biliaire. La corrélation entre le pH et la concentration en acides biliares était de 0.36 (p<0.001) et entre le pH et l'amylasémie, de 0.48 (p<0.001). Si on prend un pH > 4 pour définir le reflux alcalin, la sensibilité était de 84%. Par rapport aux dosages des acides biliares (la méthode de référence actuellement) ou de l'amylasémie, cette mesure est une méthode simple, peu gênante pour le patient et à l'avantage de quantifier le reflux pendant une période de 24 heures.
Resumen
En el presente estudio nos propusimos comparar los resultados de la medición del reflujo duodenogástrico mediante la monitoría de 24 horas del pH intragástrico y la aspiración nasogástrica para el análisis de las concentraciones de ácido biliar y alfa amilasa. Se estudiaron ocho pacierites a los cinco meses o más leugo de cirugía biliar o gástrica. El coeficiente de correlación de la concentración de pH y concentración de ácido biliar fue 0.36 (p<0.001) y el de pH y concentración de amilasa fue 0.48 (p<0.001). Al tomar un pH >4.0 como indicativo de reflujo duodenogástrico, se halló una sensibilidad de 84% en comparación con la concentración de ácido biliar o de amilasa (la cocentración de ácido biliar ha sido el método “estándar” de medición de reflujo duodenogástrico). La monitoría del pH es un método relativamente simple de realizar, causa mínima incomodidad al paciente y permite medir episodios de reflujo duodenogástrico en el curso de un período continuo de 24 horas.
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Brown, T.H., Holbrook, I., King, R.F.G. et al. 24-Hour intragastric pH measurement in the assessment of duodenogastric reflux. World J. Surg. 16, 995–999 (1992). https://doi.org/10.1007/BF02067015
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DOI: https://doi.org/10.1007/BF02067015