The significance of gastric bile reflux seen at endoscopy

Salah M. Nasrallah, Gerald S. Johnston, Thomas R. Gadacz, Kookim M. Kim

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


We evaluated the significance of bile seen in the stomach at the time of endoscopy. Twenty-three percent of 110 consecutive patients undergoing elective panendoscopy were found to have bile in their stomachs. Gastric biopsies were obtained from these patients. To assess the significance of bile reflux, the patients underwent a quantitative gastric bile analysis on two separate days. On day 1, gastric juice was aspirated by nasogastric suction, and bile acid concentrations were measured. On day 2, bile reflux into the stomach was quantitated by scintiscan measurement of gastric nucleotide after intravenous administration of 99mTc-DISIDA. Approximately half the patients with bile reflux showed histologic evidence of mucosal injury. However, fewer than half with histologic injury had significant bile reflux when measured by quantitative methods. There was no correlation among the gastric bile acid concentration, degree of histologic injury, or severity of endoscopic changes. We conclude that finding bile reflux at endoscopy is probably of no clinical significance.

Original languageEnglish (US)
Pages (from-to)514-517
Number of pages4
JournalJournal of clinical gastroenterology
Issue number5
StatePublished - Oct 1987
Externally publishedYes


  • Bile reflux
  • Enterogastric reflux
  • Gastritis

ASJC Scopus subject areas

  • Gastroenterology


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