ISSN 2398-2969      

Gastroduodenal reflux

icanis
Contributor(s):

Ken Harkin

James Simpson

Synonym(s): Biliary reflux, bilious vomiting syndrome


Introduction

  • Bile and intestinal secretion 'normally' reflux into stomach.
  • Gastric contractions return secretion to duodenum.
  • Abnormal reflux of duodenal fluid through relaxed pyloric sphincter → duodenal fluid/bile damages gastric mucosal barrier → gastritis/ulceration.
  • Cause: abnormal gastric motility allowing reflux.
  • Signs: chronic vomiting bile-stained fluid in early morning.
  • Diagnosis: signs.
  • Treatment: alter feeding regime +/- metoclopramide.

Pathogenesis

Etiology

  • Failure of 'housekeeper' gastric contractions to clear refluxed bile and intestinal secretion back into duodenum.
  • May also be observed with other chronic gastric diseases.

Predisposing factors

General
  • Period of fasting or resting.

Pathophysiology

  • Normally bile plus intestinal secretion refluxes back into stomach.
  • Whole body (housekeeper) contractions of stomach clear secretion back into duodenum.
  • Failure of these contractions permits retention of secretion on gastric mucosal surface → inflammation and occasionally erosions.

Timecourse

  • Often chronic condition.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Guilford W G & Strombeck D R (1996)Acute gastritis. In:Small Animal Gastroenterology. Strombeck (ed), 3rd edn. W B Saunders, Philadelphia, p 261.

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