Significance of Measurements of pH and Total Bile Acids Concentration in Gastric Juice in Patients with Reflux Esophagitis

Abstract

We investigated whether pH and total bile acids concentration in refluxed esophageal fluid reflect those in gastric juice in patients with reflux esophagitis.
Thirteen patients with reflux esophagitis (8 men and 5 women ; average age : 71.3 years) were examined. Reflux esophagitis was classified according to the Savary-Miller classification. Refluxed esophageal fluid and gastric juice were collected using a novel device. The total bile acids concentration and pH in the collected samples were measured using the enzymic method and a pH meter.
Refluxed esophageal fluid could be collected in 1 of 4 patients with stage I reflux esophagitis and all patients with stage II and IV reflux esophagitis. More than 200µM of bile acids, which may be sufficient cause esophageal injury in acidic conditions could be obtained in the refluxed esophageal fluid. The relationship between total bile acids concentration and pH in refluxed esophageal fluid and gastric juice showed a positive correlation.
We concluded that bile acids are one of the major factors in the onset of reflux esophagitis. For evaluation of aggressive factors in reflux esophagitis, gastric juice can be substituted for refluxed esophageal fluid.