Pathogenetic factors affecting gastroesophageal reflux in patients with esophagitis and concomitant duodenal ulcer: a multivariate analysis.

AIM:To assess the relationship between gastric acid output (GAO) and both pattern of gastroesophageal reflux (GER) and esophageal lesions,and to evaluate the role of GAO and other potential pathogenetic factors in the development of esophagitis.METHODS:Gastric acid secretory testing and 24h intraesophageal pH monitoring were performed in 31 patients with esophagitis and concomitant duodenal ulcer (E+DU) and compared with those of 72 patients with esophagitis (E) alone.RESULTS: The GAO in patients with E+DU was significantly higher than in patients with E (P <0.05). There was no significant difference between the two groups of patients as to endoscopicl findings and parameters of GER (P >0.05). A multiple regression analysis with stepwise deletion showed that the pre-sence of hiatal hernia (HH), GER in upright position and age appeared to correlate significantly with the presence of esophagitis.CONCLUSION:No parallel relationship between GAO and severity of GER or esophageal lesions exists in patients with E+DU, and that GAO is not a major pathogenetic factor in GER disease.