[Does the finding of a bilious mucous lake during endoscopy have physiopathological significance? Study of gastric pH during 24 hours].

The aim of this study was to determine if there was any relationship between the presence of bile in the stomach at endoscopy and the nycterohemeral variations of the gastric pH. Endoscopy and 24 hour gastric pH monitoring with radiotele-pHmetry were performed in 38 patients. These patients were then divided into two groups according to the color of the mucous lake at endoscopy: group A (15 patients) in which there was a clear mucous lake and group B (23 patients) in which a bilious mucous lake was found. In group A, spontaneous alkalinizations (SA) were uncommon and almost always lasted less than 30 min. In group B, SA were more frequent and more prolonged (p less than 0.01), especially those lasting more than 30 min (p less than 0.001). In this group, the number and duration of SA were significantly higher during the night. These results suggest that duodenogastric reflux may be responsible for the SA observed in patients with a bilious mucous lake. This hypothesis, however, needs further confirmation especially concerning the analysis of the gastric contents during the periods of alkalinization.