Oesophageal clearance of acid and bile: a combined radionuclide, pH, and Bilitec study

Koek G H; Vos R; Flamen P; Sifrim D; Lammert F; Vanbilloen B; Janssens J; Tack J
January 2004
Gut;Jan2004, Vol. 53 Issue 1, p21
Academic Journal
BACKGROUND: Studies combining pH and Bilitec monitoring found a high prevalence of both acid and duodeno-gastro-oesophageal reflux in severe reflux disease. Clearance of refluxed material is a major defence mechanism against reflux. Several studies have been devoted to oesophageal acid clearance but oesophageal clearance of refluxed duodenal contents (DC) has rarely been addressed. Aim: To compare oesophageal acid and DC clearance. METHODS: Ten healthy volunteers (five women, mean age 23 (1) years) were studied. Firstly, a balloon tip catheter, positioned in the duodenum under fluoroscopy, was used to aspirate DC after stimulation by a high caloric liquid meal (200 ml, 300 kcal). During the second session, pH and Bilitec probes were positioned 5 cm above the lower oesophageal sphincter and a small infusion catheter was introduced into the proximal oesophagus. The subject was placed supine under a gamma camera. One of two different solutions (DC mixed with 0.2 mCi Tc99m pertechnetate or citric acid (pH 2) mixed with 0.2 mCi Tc99m pertechnetate) was infused into the proximal oesophagus and the subject was instructed to swallow at 20 second intervals. Clearance was assessed using scintigraphy (dynamic acquisition, one frame per second in the anterior view; calculation of time to clear peak counts to background level), pH (time to pH<4) or Bilitec (time absorbance >0.14) monitoring, with or without continuous saliva aspiration. Each condition was studied twice in a randomised design; measurement time was four minutes, interrupted by water flushing, with a two minute rest period. Results are given as mean (SEM) and were compared by Student''s t test and Pearson correlation. RESULTS: Scintigraphic evaluation showed a volume clearance time of 29 (3) seconds for acid and 28 (9) seconds for DC (NS). Saliva aspiration had no significant influence on volume clearance of acid or DC (28 (4) and 30 (13) seconds, respectively; NS). pH monitoring showed an acid clearance time of 217 (15) seconds, which was significantly prolonged to 324 (30) seconds during saliva aspiration (p<0.05). Bilitec monitoring showed a DC clearance time of 131 (27) seconds, which was not significantly prolonged by saliva aspiration (176 (36) seconds; p = 0.08). DC clearance was faster than acid clearance, either without or with saliva aspiration (p<0.055 and p<0.05, respectively). CONCLUSIONS: Under experimental conditions, liquid acid and DC solutions have comparable volume clearances. Chemical clearance occurs slightly faster for DC than for acid, and saliva plays a major role in the clearance of acid only.


Related Articles

  • Normal and Abnormal Proximal Esophageal Acid Exposure: Results of Ambulatory Dual-Probe pH Monitoring. Dobhan, Richard; Castell, Donald O. // American Journal of Gastroenterology;Jan1993, Vol. 88 Issue 1, p21 

    Ambulatory esophageal pH monitoring was performed in 26 normal volunteers, 20 patients with normal distal acid exposure, and 23 patients with abnormal distal acid exposure in an attempt to define normal values for proximal esophageal acid exposure using a standardized technique. We used a dual...

  • Effect of pH, foreign ions and temperature on radionickel sorption onto bentonite from Inner Mongolia, China. Jia, Wenbao; Lu, Songsheng // Journal of Radioanalytical & Nuclear Chemistry;Mar2014, Vol. 299 Issue 3, p1417 

    The development of nuclear power releases large amounts of radionuclides into the natural environment. Herein, the sorption of radionuclide Ni on bentonite from Gaomiaozi county (Inner Mongolia, China) at different experimental conditions such as pH, contact time, ionic strength, foreign cations...

  • Making sense of oesophageal contents. Fox, Mark; Schwizer, Werner // Gut;Apr2008, Vol. 57 Issue 4, p435 

    The author comments on the study which compares the findings of combined pH and impedance monitoring among patients with endoscopy negative reflux disease (ENRD). He believes that this change of focus and the enhanced ability in identifying the causes of symptoms and disease with the use of...

  • Annals of Surgery: Bile - not acid - is bad guy in triggering precancerous condition associated with reflux disease.  // Biomedical Market Newsletter;4/28/2012, Vol. 21, p1 

    The article presents information on a study, according to which, bile plays an important role in the development of Barrett's esophagus.

  • Screening of Bacteriocin Producing Lactic Acid Bacteria for Probiotic Properties. Kaur, Simrit; Tanushree; Kumar, Pradyuman // International Journal of BioSciences & Technology;2012, Vol. 5, p6 

    The concept of providing functional foods including beneficial probiotic components is gaining attention in recent years. Therefore, this study was aimed to isolate potential probiotic Lactic Acid Bacteria (LAB) from various sources. A total of 66 LAB strains were selectively isolated from...

  • Diagnostic Accuracy of Sentinel Lymph Node Biopsy in Axillary Lymph Nodes at the Early Stages of Breast Cancer. Pusina, Sadat // Medical Archives / Medicinski Arhiv;Aug2013, Vol. 67 Issue 4, p252 

    Introduction: For almost 100 years, standard procedure for evaluation of axillary lymph node status has been axillary nodes dissection (ALDN)--dissection of 1st, 2nd or possible 3rd level of axilla. Use of less invasive evaluation methods of axillary node pathologically (PH) status of...

  • Effects of pH, concentration and temperature on radionuclides sorption onto polyhydroxyethyl methacrylate-expanded perlite composite. Akkaya, Recep // Journal of Radioanalytical & Nuclear Chemistry;Jan2013, Vol. 295 Issue 1, p351 

    Poly (hydroxyethylmethacrylate-expanded perlite) [P(HEMA-EP)], was synthesized and its adsorptive features were investigated for natural radionuclides (TI, Ra, Bi, Ac and Pb) in aqueous media at differing initial pH, initial radionuclides concentration and adsorption thermodynamics. The amounts...

  • Adsorption of Tc on aluminum oxide. Skuridin, V.; Stasyuk, E.; Nesterov, E.; Sadkin, V.; Rogov, A. // Radiochemistry;Oct2011, Vol. 53 Issue 5, p529 

    Adsorption of Tc under static and dynamic conditions on aluminum oxides subjected to various acid treatments at pH from 7.29 to 1.26 (until the reaction of the oxide with the acid fully ceased) was studied. In batch experiments, the maximal adsorption of T, more than 30% of the radionuclide...

  • Uranium in ground water samples of Northern Greece. Ioannidou, A.; Samaropoulos, I.; Efstathiou, M.; Pashalidis, I. // Journal of Radioanalytical & Nuclear Chemistry;Aug2011, Vol. 289 Issue 2, p551 

    The activity concentrations of U and U have been determined in groundwater samples of hot springs and deep wells in Northern Greece. The analysis was performed by alpha spectroscopy after pre-concentration and separation of uranium by cation exchange (Chelex 100 resin) and finally its...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics