Acid gastro-oesophageal reflux pattern in duodenal ulcer patients related to dyspeptic symptoms

Abstract

Thirty-nine patients with uncomplicated duodenal ulcer were divided into two groups, one with pathological acid gastro-oesophageal reflux and one with non-pathological acid gastro-oesophageal reflux, on the basis of the results of a 12-h pH recording in the lower part of the oesophagus. The duodenal ulcer patients with pathological acid gastro-oesophageal reflux had a longer history of the disease (p less than 0.05), but there was little correlation between the symptoms of heartburn and regurgitation and acid gastro-oesophageal reflux. The gastro-oesophageal sphincter pressure was lower (p less than 0.05) in the patients with pathological acid gastro-oesophageal reflux. Acid clearing was prolonged in both duodenal ulcer groups (p less than 0.05) compared with asymptomatic volunteers. At low pH, a reflux episode lasted longer in both duodenal ulcer groups than in asymptomatic volunteers. Clearing of a reflux episode with low pH needed longer duration and/or increased peristaltic activity than a reflux episode with higher pH in both duodenal ulcer groups. In conclusion, acid gastro-oesophageal reflux is not the only important factor in releasing the symptoms of heartburn and regurgitation. All the duodenal ulcer patiets in this investigation had changes in the peristaltic activity in the oesophageal body. Pathological acid gastro-oesophageal reflux is found in duodenal ulcer patients with a low gastro-oesophageal sphincter pressure and a long history of the disease.