Livzan Maria A, Mozgovoi Sergei I, Gaus Olga V, Bordin Dmitry S, Kononov Alexei V
Department of Faculty Therapy and Gastroenterology, Omsk State Medical University, 644099 Omsk, Russia.
Department of Pathological Anatomy, Omsk State Medical University, 644099 Omsk, Russia.
Diagnostics (Basel). 2023 Jan 4;13(2):186. doi: 10.3390/diagnostics13020186.
This article systematizes available data from the literature on biliary gastritis (BG) in order to increase the awareness of specialists about the latest possibilities for diagnosing the disease. BG occurs as a result of pathological duodenogastric reflux. In patients with a preserved duodenogastric junction, the dominant factor is represented by motor disorders of the upper digestive tract (primary biliary gastritis), while in patients recovering from surgical interventions it is represented by structural changes (secondary biliary gastritis). Progressive BG can lead to atrophy of the gastric mucosa, intestinal metaplasia, epithelial dysplasia, and eventually to gastric cancer. Diagnostic methods for BG are carried out to identify risk factors, exclude alarm symptoms and identify persistent motor disorders and pathological reflux (24 h pH-impedancemetry, hepatobiliary scintigraphy, 24 h monitoring of bilirubin content in the reflux using a Bilitec 2000 photometer), as well as to diagnose gastritis itself (esophagogastroduodenoscopy, morphological gastrobiopsy examination). The diagnosis of BG should be based on a multidisciplinary approach that combines a thorough analysis of a patient's complaints, an anamnesis of the disease, and the results of endoscopic and histological research methods.
本文对文献中关于胆汁反流性胃炎（BG）的现有数据进行了系统化整理，以提高专科医生对该疾病最新诊断方法的认识。BG是由病理性十二指肠-胃反流引起的。在十二指肠-胃连接处完整的患者中，主要因素是上消化道运动障碍（原发性胆汁反流性胃炎），而在接受手术干预后恢复的患者中，主要因素是结构改变（继发性胆汁反流性胃炎）。进展性BG可导致胃黏膜萎缩、肠化生、上皮发育异常，并最终发展为胃癌。BG的诊断方法包括识别危险因素、排除警示症状、识别持续性运动障碍和病理性反流（24小时pH阻抗监测、肝胆闪烁显像、使用Bilitec 2000光度计对反流中的胆红素含量进行24小时监测），以及诊断胃炎本身（食管胃十二指肠镜检查、形态学胃活检检查）。BG的诊断应基于多学科方法，该方法结合了对患者主诉的全面分析、疾病史以及内镜和组织学研究方法的结果。
