Statement of financial support: This study was supported by a grant from the Natural Science Foundation (Y205074) of Zhejiang Province, China.
Bile and acid reflux in the pathogenesis of reflux oesophagitis in children
Article first published online: 19 JAN 2009
© 2008 The Authors. Journal compilation © 2008 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 45, Issue 1-2, pages 64–67, January/February 2009
How to Cite
Jiang, M., Chen, J., Chen, F., Yu, J., Liang, J., Zhang, Y. and Ou, B. (2009), Bile and acid reflux in the pathogenesis of reflux oesophagitis in children. Journal of Paediatrics and Child Health, 45: 64–67. doi: 10.1111/j.1440-1754.2008.01431.x
- Issue published online: 19 JAN 2009
- Article first published online: 19 JAN 2009
- Accepted for publication 12 July 2008.
- bilirubin monitoring;
- gastro-oesophageal reflux;
- pH monitoring;
- reflux oesophagitis
Aim: The aim of this study was to investigate the role of bile and acid reflux in the pathogenesis of reflux oesophagitis (RE) in children.
Methods: A total of 44 patients aged 5–17 years with gastro-oesophageal reflux symptoms were enrolled. Simultaneous 24-h oesophageal Bilitec 2000 (Medtronic Instruments, Minneapolis, MN, USA) bilirubin monitoring and pH monitoring, in biopsy of oesophageal mucosa by gastro-endoscopy, were performed in all patients.
Results: According to the diagnostic criteria of pathological acid reflux and pathological bile reflux, 10 of 44 cases (22.7%) had acid reflux, 10 (22.7%) had isolated bile reflux, 16 (36.4%) had mixed acid and bile reflux, and the other eight (18.2%) had no reflux. Significant difference was observed in the ratio of different patterns of reflux between the RE group (26 cases) and the non-erosive reflux disease (NERD) group (18 cases) (χ2 = 9.096, P < 0.01). All the parameters of acid reflux in the RE group were higher significantly than that in the NERD group (P < 0.05 or P < 0.01). A total of 20 out of 26 cases (76.9%) with RE had oesophageal acid reflux as against six out of 18 cases (33.3%) in patients with NERD (P < 0.01). The difference of each parameter of bile reflux had not reached significance between the two groups.
Conclusions: Mixed reflux is the predominant form of reflux in the causation of oesophageal mucosal injury in children. Isolated bile reflux also plays a role in the development of RE, although only in patients without acid reflux.