Abstract
The causative relation of bile acid contained in the gastric juice to gastric mucosal lesions was studied. The levels and subfractions of bile acid in the fluid were measured using high performance liquid chromatography. Gastric atrophy was endoscopically determined, according to the Kimura & Takemoto classification, and the presence of intestinal metaplasia in the antrum was evaluated by the methylene blue staining method. Grades were divided into 5 subgroups based on the area of methylene blue absorbtion. In this study 69 + 26 subjects were examined. Our findings showed that the redness of the prepylorus in 5 cases that had high levels of bile acid (especially primary glycine conjugated bile acid in the gastric juice) and the redness of the stoma in 18 out of 26 post operative cases, was attributed to goblet cell metaplasia- like tissue through muco-histological study using PAS Alician Blue staining. The area of intestinal metaplasia extended from I to V and correlated with the elevation of bile acid levels in the gastric juice. Of special interest, we found that these levels of taurine conjugated bile acids which contain taurocholic acid were significantly increased in the grade V group in comparison to that of the grade I group. In considering gastric mucosal lesions, it was found that bile acid levels in the ulcer patient were higher than those in the patient with gastric erosion.by methylene blue of the prepylorus of the case of the highly bile acid concentration and post operative 3 years case.
