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Morphological transformation in esophageal submucosa by bone marrow cells: esophageal implantation under external esophageal perfusion.

Accumulating clinical and experimental studies indicate that Barrett's esophagus might arise through multipotential stem cells under the stress of gastroesophageal reflux. Previously, we have presented a novel external pump perfusion rat model and demonstrated that perfusion with both acid and bile can induce severe esophagitis in 1 week with a similarly pathological change seen in humans. The aim of this study was to investigate the histological changes of esophagus after bone marrow cell engraftment with bile and acid perfusion. The external pump perfusion procedure involved implantation of

Elevated bile amylase level without pancreaticobiliary maljunction is a risk factor for gallbladder carcinoma.

BACKGROUND: Elevated bile amylase level in patients with pancreaticobiliary maljunction (PBM) or high confluence of pancreaticobiliary ducts (HCPBD) is well known as a risk factor for gallbladder carcinoma (GBC) development. However, the effects of occult pancreaticobiliary reflux (OPR), a condition characterized by high bile amylase level in the presence of an anatomically normal pancreaticobiliary junction, on GBC development remain unclear. The aim of this study was to assess the relationship between OPR and GBC. METHODS: Clinicopathological data of 52 patients who were preoperatively diag

Visualization of pancreaticobiliary reflux in anomalous pancreaticobiliary junction by secretin-stimulated dynamic magnetic resonance cholangiopancreatography.

PURPOSE: To assess the utility of secretin-stimulated dynamic MR cholangiopancreatography (MRCP) for the visualization of pancreaticobiliary reflux in patients with anomalous pancreaticobiliary junction (PBJ). MATERIAL AND METHODS: Ten controls and seven patients diagnosed as having anomalous PBJ were prospectively examined by dynamic MRCP after secretin injection using a breath-hold, single-shot turbo spin-echo T2-weighted sequence. The optimal MRCP section was repeated 35 times at approx. 10-second interval after secretin injection; the acquisition time was 4 s per image. The signal intensi

COX-2 induction by unconjugated bile acids involves reactive oxygen species-mediated signalling pathways in Barrett's oesophagus and oesophageal adenocarcinoma.

OBJECTIVES: Bile reflux contributes to oesophageal injury and neoplasia. COX-2 is involved in both inflammation and carcinogenesis; however, the precise mechanisms by which bile acids promote COX-2 expression in the oesophagus are largely unknown. We analysed the molecular mechanisms that govern bile acid-mediated expression of COX-2 in Barrett's oesophagus and oesophageal adenocarcinoma (OA). DESIGN: The effects of bile acids on COX-2 expression were analysed in immortalised Barrett's oesophagus and OA cells using immunoblotting and transient transfections. Pharmacological inhibitors, phosph…

Evaluating the application value of the modified Billroth-II with Braun anastomosis in laparoscopic distal gastric cancer radical surgery.

INTRODUCTION: This retrospective study aims to compare the feasibility and efficacy of the modified Billroth-II with Braun (B-II Braun) reco … a 6-month short-term follow-up, endoscopic examination in the B-II Braun group revealed 27 cases of bile reflux and 15 cases (10.3%) of Grade 2 gastritis, with no cases of Grade 2 food residue. However, there was no statistically significant difference between the two groups in terms of food residue remaining in the residual stomach at 6 months ( P = 0.29), g …

Effect of cholecystectomy on gastroesophageal and duodenogastric reflux.

OBJECTIVE: The majority of patients experience resolution of their symptoms after cholecystectomy, but a minority either find their symptoms … to affect pre- or postoperative values. CONCLUSIONS: Cholecystectomy does not result in increased bile reflux into the stomach or increased gastroesophageal acid reflux. Those patients who had increased postoperative duodenogastric reflux were entirely asymptomatic. The symptoms of postcholecystectomy syndrome are unlikely to be related to increased duodeno …

One-Anastomosis Versus Roux-en-Y Gastric Bypass in the Resolution of Comorbidities: A Non-inferiority Meta-analysis and Meta-regression.

Bariatric surgery is effective for treating obesity and its comorbidities, but the optimal technique remains debated. This meta-analysis compared one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) in comorbidity remission and postoperative outcomes. We analyzed 12 trials, assessing T2DM, hypertension, and sleep apnea remission, as well as postoperative complications. Statistical analyses included risk differences (RD) and risk ratios (RR). OAGB was non-inferior to RYGB for T2DM remission (RD -1%; 95% CI -10% to 8%) but had higher risks of bile reflux (RR 7.62; 95% CI 1.9…

[Study on therapeutical effect of Canghuopingwei granules on chronic gastritis in rats].

OBJECTIVE: To investigate the therapeutical effect of Canghuopingwei Granules on chronic gastritis in rats. METHODS: Rat models of chronic gastritis and bile reflux gastritis were used. After rat models were established, the rats were divided into 6 groups and were treated with different drugs. The tissue samples were obtained after one week. The volume of gastric juice, acidity of gastric juice and pepsase activity were determined, and changes of the gastric mucosa were studied by microscopy. RESULTS: The acidity of gastric juice was reversed with Canghuopingwei granules treatment. Gastric …

Association between bile area in the duodenal bulb and abdominal symptoms: Quantitative analysis using blue laser imaging.

Bile acids are strongly associated with the pathogenesis of functional gastrointestinal diseases. In recent years, blue laser imaging (BLI) endoscopy has emerged as a novel image-enhanced endoscopic method, which illustrates bile as a reddish hue. The present study investigated the factors that affect the area of bile in duodenal bulbs using BLI. For this purpose, patients (356 cases) who underwent upper endoscopy with BLI between April, 2017 and December, 2019, and completed patient background and symptom questionnaires [Constipation Scoring System (CSS), Bristol Stool Form Scale (BSFS) and F

Совпадение в полном тексте источника
… Although Barrett's esophagus and upper abdominal symptoms were not associated with bile area in the present study, a causal association is unclear as bile reflux into the stomach was not assessed. … bile reflux gastritis Clin Gastroenterol Hepatol 16 1389 1392 2018 10.1016/j.cgh.2018.02.034 29505908 …

Cell culture models for studying the development of Barrett's esophagus: a systematic review.

BACKGROUND: Barrett's esophagus (BE) is a premalignant condition caused by chronic gastroesophageal reflux. BE patients have an increased risk of developing esophageal adenocarcinoma (EAC). As many aspects of this condition are still unknown, there is a need for in vitro models to study BE development. AIM: To review the literature on cell lines and incubation conditions for studying BE development. METHODS: A literature search was performed using PubMed, EMBASE and the Cochrane library, combining the words esophagus, cell line, culture, Barrett's, bile, acid, exposure, reflux and adenocarci

Non-Acid Fluid Exposure and Esophageal Squamous Cell Carcinoma.

Esophageal squamous cell carcinoma (ESCC) accounts for the large majority of esophageal cancer cases worldwide. In this review, we examine t … Non-acid reflux has been associated with ESCC in small observational studies, and in animal models bile reflux can promote the development of ESCC. Associations have been found between increased ESCC risk and atrophic gastritis, a history of partial gastrectomy, and proton pump inhibitor use, all of which raise the pH of refluxate. Additionally, a minimally …

Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass.

INTRODUCTION: One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. METHODS: We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014. One year later, she consulted for recurrent heartburns. An upper GI endoscopy showed pouchitis and bile reflux in the …

The "Barrett syndrome" (the columnar-lined lower oesophagus): an acquired condition secondary to reflux oesophagitis. A case report with discussion of pathogenesis.

A case of the "Barrett syndrome" in a patient with severe ulcerating reflux oesophagitis is reported. Evidence indicating that it is an acquired condition caused by reflux of bile-contaminated gastric juice is presented. The "Barrett ulcer" and the oesophagitis healed following a partial gastrectomy with a Roux-en Y gastrojejunostomy. The substitution of the squamous epithelium of the lower 15 cm of the oesophagus by columnar epithelium of cardia type is apparently irreversible.

In vitro and ex vivo models of extended reflux exposure demonstrate that weakly acidic mixed reflux heightens NF-kB-mediated gene expression.

The development of Barrett's esophagus and its progression to adenocarcinoma are clearly linked to reflux of acid and bile. Our objective in this study was to develop an optimized ex vivo biopsy culture technique to study the molecular signaling events induced after insult with individual refluxate constituents. We illustrate the utility of this method by showing results for NF-kB centered cell signaling, and compare the results with those obtained from esophageal cell lines. We show that upregulation of the two NF-kB target genes show differences in pH preference, with IL-8 being preferential

Obliteration of the distal bile duct in the development of congenital choledochal cyst.

The authors report the first case of antenatally diagnosed choledochal cyst having evidence of early fetal bile drainage and complete obliteration of the distal bile duct. This disputes the traditional hypothesis of reflux of pancreatic enzymes and supports the recent theory of primary obstruction as the etiologic cause of choledochal cyst. Coexisting congenital hypothyroidism and pulmonary stenosis had not been reported previously.

Duodenogastro-oesophageal reflux.

The role of duodenogastro-oesophageal reflux (DGOR), once erroneously termed 'bile reflux', in causing oesophageal mucosal damage has been an area of interest in both animal and human studies. However, due to the lack of appropriate techniques for accurately measuring DGOR, extrapolation of findings from animal studies to humans was difficult to make. The recent advent of the Bilitec system, an ambulatory bilirubin monitoring device, is increasing our knowledge of the specific role of DGOR in oesophageal diseases. Studies suggest that the DGOR without acid reflux may result in symptoms but unl…

[The relationship of duodenogastric reflux symptoms with the quantity of intragastric bilirubin].

OBJECTIVE: To investigate the relationship of the symptoms of duodenogastric reflux (DGR) with the quantity of intragastric bilirubin. METHODS: An apparatus (Bilitec 2000) was used for the monitoring of 24-hour intragastric bile in 18 menopause patients with functional dyspepsia (MPFD) accompanied with the symptoms, such as heartburn, epigastric pain, nausea and vomiting. RESULTS: In most of the time, the symptoms of DGR appeared when intragastric bilirubin could be detected by Bilitec 2000. Furthermore, the severity of symptoms showed good correlation with the amount of bile refluxed into s…

Inflammation at the cardio-oesophageal junction: relationship to acid and bile exposure.

BACKGROUND: The aetiology of inflammation in cardiac mucosa at the gastro-oesophageal junction (carditis) is unclear, although gastro-oesophageal reflux has been suggested. OBJECTIVES: To correlate histological features of carditis with oesophageal acid exposure (gastro-oesophageal reflux) and proximal gastric bile exposure (duodenogastric reflux) in patients with symptoms of gastro-oesophageal reflux disease (GORD). METHODS: Sixty-six patients with reflux symptoms underwent endoscopy with biopsy, oesophageal manometry, 24-h oesophageal pH testing and 24-h proximal gastric Bilitec 2000 testi

A new paradigm for GERD pathogenesis. Not acid injury, but cytokine-mediated inflammation driven by HIF-2α: a potential role for targeting HIF-2α to prevent and treat reflux esophagitis.

Traditionally, reflux esophagitis was assumed to develop as a caustic, chemical injury inflicted by refluxed acid. Recently, however, studies in rats and humans suggest that reflux esophagitis develops as a cytokine-mediated inflammatory injury, with hypoxia inducible factor (HIF)-2α playing a major role. In response to the reflux of acid and bile, HIF-2α in esophageal epithelial cells becomes stabilized, thereby increasing production of pro-inflammatory cytokines that attract T lymphocytes and other inflammatory cells to damage the esophagus. Recent studies have identified small molecule inhi

[Duodenogastric reflux after vagotomy and pyloroplasty (author's transl)].

In 27 patients after selective or truncal vagotomy and pyloroplasty the occurrence of duodenogastric reflux was checked by two methods, by the measurement of Bromsulphalein (BSP)-concentration in the gastric aspirate after BSP was given intravenously and by instillation of a barium meal in the second part of the duodenum followed by upper GI-series. In 20 of 23 patients reflux was recorded radiologically, in 18 of 27 patients reflux was shown by the BSP-Method. Proven bile reflux was associated with major postoperative discomfort, such as epigastric fullness, nausea and epigastric pain, it was…