Duodenogastric reflux after gastric surgery.

Nineteen patients with a history of heartburn, bile vomiting, and postprandial pain after gastric surgery have been compared with 16 symptom-free gastrectomized patients with regard to bile reflux, gastric emptying rate, and gastric mucosal changes. Bile reflux was determined by an isotope-derivative method. Gastric emptying of a liquid meal was studied by a dye dilution technique. Gastric mucosal morphology was studied in biopsies taken at gastroscopy. A significantly higher degree of bile reflux could be demonstrated in patients with symptoms than in symptom-free patients. Gastric emptying of a liquid meal occurred at the same rate in both groups. There was no correlation between the gastric emptying rate and the amount of bile reflux. The gastritis was of the same severity in patients with and without symptoms and was not related to the degree of bile reflux.