Materiały źródłowe

• #1 Bile Reflux: Symptoms, Treatment, Causes & What It Is

  https://my.clevelandclinic.org/health/diseases/22056-bile-reflux

  Bile reflux is not thought to be common in otherwise healthy individuals. […] Bile reflux is most commonly recognized as a complication of surgery, particularly stomach surgery that bypasses, damages or replaces the pyloric valve. […] Bile (or non-acid) reflux is not common, but its a known complication of certain surgeries.

• #2 Biliary reflux – Wikipedia

  https://en.wikipedia.org/wiki/Biliary_reflux

  Bile reflux is very infrequent in healthy individuals. […] Bile acids are frequently present in the gastroesophageal refluxate, and thus can cause inflammatory and neoplastic changes in the upper aerodigestive tract. […] Bile reflux appears to be a causal factor in human hypopharyngeal squamous cell carcinoma.

• #3 Bile reflux: Symptoms, causes, treatment and more

  https://www.medicalnewstoday.com/articles/bile-reflux

  Bile reflux tends to be uncommon in people who do not have any health problems, but it is a well-known complication of certain surgeries. […] Bile reflux can happen for the following reasons: as a complication of surgery, such as bariatric or gallbladder surgery. […] Bile reflux usually requires medications and, sometimes, surgery. If left untreated, bile reflux can irritate the GI tract and increase the risk of complications.

• #4 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Bile reflux gastritis (BRG), a kind of gastrointestinal disorder in clinical practice, is characterized by regurgitation and inflammation. However, lack of guidelines leads to simple cognition and even ignorance of this disease for clinicians. Primarily, making the pathogenesis of BRG clear contributes to a correct and general understanding of this disease for physicians. […] In terms of its prevalence, a study including 804 cases where there was an endoscopic examination for abdominal pain found bile reflux was seen in 23.9% patients. Another research observed that the prevalence of BRG was 16.7% and 61.8% in the control group, who had never undergone any biliary interventions and the postcholecystectomy group who had undergone cholecystectomy. […] The prevalence of DGER among all GERD patients ranged from 10% to 97%.

• #5 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Bile reflux gastritis (BRG), a kind of gastrointestinal disorder in clinical practice, is characterized by regurgitation and inflammation. However, lack of guidelines leads to simple cognition and even ignorance of this disease for clinicians. Primarily, making the pathogenesis of BRG clear contributes to a correct and general understanding of this disease for physicians. […] In terms of its prevalence, a study including 804 cases where there was an endoscopic examination for abdominal pain found bile reflux was seen in 23.9% patients. Another research observed that the prevalence of BRG was 16.7% and 61.8% in the control group, who had never undergone any biliary interventions and the postcholecystectomy group who had undergone cholecystectomy. […] The prevalence of DGER among all GERD patients ranged from 10% to 97%.

• #6 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1058566

  Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. […] Endoscopic bile reflux was common findings with young adults (30’s) at outpatients clinic. […] Bile reflux also had distinguishable ultra-structural changes identifiable by EM. […] GB dysfunction were identified as significant risk factors for BRI (+) group. […] The BRI (+) group had more old age, GB dysfunction than BRI (-) group. […] The BRI (+) group correlated with GB dysfunction (OR, 2.41; 95% CI, 0.62 to 9.31). […] Endoscopic bile reflux (9.7%) is a very common disease encountered in the outpatients clinic. It was found to be common in young adults (30’s) and more predominant in females. […] Bile reflux inhibited colonization of H. pylori in the stomach. […] BRI (+) group had more old age and GB dysfunction than BRI (-) group.

• #7 Cited

  https://www.koreamed.org/SearchBasic.php?RID=2284011&DT=1

  Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. […] Endoscopic bile reflux was common findings with young adults (30’s) at outpatients clinic. […] GB dysfunction were identified as significant risk factors for BRI (+) group.

• #8 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Bile reflux gastritis (BRG), a kind of gastrointestinal disorder in clinical practice, is characterized by regurgitation and inflammation. However, lack of guidelines leads to simple cognition and even ignorance of this disease for clinicians. Primarily, making the pathogenesis of BRG clear contributes to a correct and general understanding of this disease for physicians. […] In terms of its prevalence, a study including 804 cases where there was an endoscopic examination for abdominal pain found bile reflux was seen in 23.9% patients. Another research observed that the prevalence of BRG was 16.7% and 61.8% in the control group, who had never undergone any biliary interventions and the postcholecystectomy group who had undergone cholecystectomy. […] The prevalence of DGER among all GERD patients ranged from 10% to 97%.

• #9 Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2653330/

  AIM: To determine the prevalence and characteristics of bile reflux in gastroesophageal reflux disease (GERD) patients with persistent symptoms who are non-responsive to medical therapy. […] The overall prevalence of bile reflux in non-responsive patients was 68.7%. […] Our findings also showed that a high percentage of GERD patients poorly responsive to PPIs have biliary reflux. We found that a high percentage (53.3%) of non-esophagitic GERD patients had pathologic bile reflux, increasing to 70% in esophagitic patients. […] This study clearly shows that the high percentage of patients poorly responsive to PPI therapy may result from poor control of DGERD. Many patients without esophagitis have simultaneous acid and bile reflux, which increases with increasing esophagitis grade.

• #10 Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

  https://www.wjgnet.com/1007-9327/full/v15/i3/334.htm

  Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors. […] The high percentage of patients poorly responsive to PPI therapy may result from poor control of duodenogastroesophageal reflux. […] Many patients without esophagitis have simultaneous acid and bile reflux, which increases with increasing esophagitis grade. […] A high percentage of GERD patients poorly responsive to PPIs have biliary reflux. […] The global prevalence of patients non-responsive to PPI therapy was 68.7%.

• #11 Bile Reflux: Symptoms, Treatment, Causes & What It Is

  https://my.clevelandclinic.org/health/diseases/22056-bile-reflux

  Bile reflux is not thought to be common in otherwise healthy individuals. […] Bile reflux is most commonly recognized as a complication of surgery, particularly stomach surgery that bypasses, damages or replaces the pyloric valve. […] Bile (or non-acid) reflux is not common, but its a known complication of certain surgeries.

• #12 Bile Reflux: Clinical Considerations – Gastroenterology Advisor

  https://www.gastroenterologyadvisor.com/features/tips-for-distinguishing-and-treating-biliary-reflux/

  Biliary reflux is difficult, yet important, to distinguish from acid reflux, in order to ensure proper treatment for these patients. […] In certain patients with bile reflux, it has been postulated that a weak or widely patent pylorus could predispose patients to this condition. […] Bile reflux may also be more common in patients with motility disorders, especially in those whose gastric or duodenal motility is reduced, including certain patients with type 2 diabetes mellitus or those taking chronic opioid medications. […] Patients who have undergone gastric surgeries where the pylorus is bypassed or disrupted may be predisposed to developing bile reflux as well. […] Additional risk factors include gallbladder dysfunction, cholecystectomy (CCY), and biliary sphincterotomy. […] Bile reflux is often seen in patients with Barrett esophagus (BE) and severe esophagitis, both of which can be identified during an esophagoduodenoscopy (EGD).

• #13 Does Bile Reflux Increase Following Cholecystectomy? – Houston Heartburn and Reflux Center

  https://houstonheartburn.com/does-bile-reflux-increase-following-cholecystectomy/

  “Gastroesophageal Mucosal Injury after Cholecystectomy: An Indication for Surveillance?” is a new study published by T. Walsh et al in the current issue of JACS (Journal of the American College of Surgeons). The authors evaluate the incidence of stomach bile pooling detected by endoscopy in patients before and after cholecystectomy. They further measure the bile reflux index, cellular proliferation marker Ki67 and tumor-suppressor gene p53 in biopsies taken from the gastro-esophageal junction and gastric antrum. The analysis show that cholecystectomy increases the incidence of bile reflux and bile induced damage of gastric and esophageal mucosa. Chronic bile induced esophagitis and gastritis increase the incidence of gastric and esophageal cancer. […] This study shows that cholecystectomy increases the risk of bile reflux and esophago-gastric mucosa injury. I suspect the risk of bile reflux and mucosal injury is highest in GERD patients who undergo an unindicated cholecystectomy.

• #14 Bile reflux: Symptoms, causes, treatment and more

  https://www.medicalnewstoday.com/articles/bile-reflux

  Bile reflux tends to be uncommon in people who do not have any health problems, but it is a well-known complication of certain surgeries. […] Bile reflux can happen for the following reasons: as a complication of surgery, such as bariatric or gallbladder surgery. […] Bile reflux usually requires medications and, sometimes, surgery. If left untreated, bile reflux can irritate the GI tract and increase the risk of complications.

• #15 Bile Reflux: Clinical Considerations – Gastroenterology Advisor

  https://www.gastroenterologyadvisor.com/features/tips-for-distinguishing-and-treating-biliary-reflux/

  Biliary reflux is difficult, yet important, to distinguish from acid reflux, in order to ensure proper treatment for these patients. […] In certain patients with bile reflux, it has been postulated that a weak or widely patent pylorus could predispose patients to this condition. […] Bile reflux may also be more common in patients with motility disorders, especially in those whose gastric or duodenal motility is reduced, including certain patients with type 2 diabetes mellitus or those taking chronic opioid medications. […] Patients who have undergone gastric surgeries where the pylorus is bypassed or disrupted may be predisposed to developing bile reflux as well. […] Additional risk factors include gallbladder dysfunction, cholecystectomy (CCY), and biliary sphincterotomy. […] Bile reflux is often seen in patients with Barrett esophagus (BE) and severe esophagitis, both of which can be identified during an esophagoduodenoscopy (EGD).

• #16 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1058566

  Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. […] Endoscopic bile reflux was common findings with young adults (30’s) at outpatients clinic. […] Bile reflux also had distinguishable ultra-structural changes identifiable by EM. […] GB dysfunction were identified as significant risk factors for BRI (+) group. […] The BRI (+) group had more old age, GB dysfunction than BRI (-) group. […] The BRI (+) group correlated with GB dysfunction (OR, 2.41; 95% CI, 0.62 to 9.31). […] Endoscopic bile reflux (9.7%) is a very common disease encountered in the outpatients clinic. It was found to be common in young adults (30’s) and more predominant in females. […] Bile reflux inhibited colonization of H. pylori in the stomach. […] BRI (+) group had more old age and GB dysfunction than BRI (-) group.

• #17 Should I Be Worried About Bile Reflux?

  https://minimallyinvasivesurgeryfl.com/what-is-bile-reflux-and-do-i-need-to-worry-about-it/

  Bile reflux most often occurs after gallbladder removal or cholecystectomy. […] If bile pushes back into the stomach for any number of reasons, anatomical or technical, this is known as bile reflux. […] Even bariatric procedures can cause bile reflux. […] These advances have dramatically reduced the incidence and severity of bile reflux. […] Only when bile begins to reflux into the esophagus do patients experience significant symptoms. […] Unfortunately, while the symptoms of bile reflux may feel the same as gastric reflux, ultimately, antacids and acid-blocking medications do not work when acid is not the main concern. […] If you have recently had a cholecystectomy and have new or worsened GERD, you should speak to your doctor. […] Ultimately, treatment for bile reflux is very successful, and most patients experience significant relief after their procedure.

• #18 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1058566

  Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. […] Endoscopic bile reflux was common findings with young adults (30’s) at outpatients clinic. […] Bile reflux also had distinguishable ultra-structural changes identifiable by EM. […] GB dysfunction were identified as significant risk factors for BRI (+) group. […] The BRI (+) group had more old age, GB dysfunction than BRI (-) group. […] The BRI (+) group correlated with GB dysfunction (OR, 2.41; 95% CI, 0.62 to 9.31). […] Endoscopic bile reflux (9.7%) is a very common disease encountered in the outpatients clinic. It was found to be common in young adults (30’s) and more predominant in females. […] Bile reflux inhibited colonization of H. pylori in the stomach. […] BRI (+) group had more old age and GB dysfunction than BRI (-) group.

• #19 Bile Reflux Gastropathy and Functional Dyspepsia

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm20102

  Bile reflux gastropathy is associated with functional dyspepsia and causes more severe symptoms. Cholecystectomy predisposes to BG and abnormal pain, and could contribute to the pathogenesis of functional dyspepsia. […] Cholecystectomy may serve as a risk factor for bile reflux into the stomach. […] To examine if cholecystectomy is a risk factor for BG and functional dyspepsia, we performed multivariate regression modeling comparing BG group (n = 90) vs NBG + NG group (n = 172). This revealed that cholecystectomy (OR, 6.60; 95% CI, 1.87-23.30; P = 0.003; Model A) was significantly associated with BG. […] Cholecystectomy appears to be a significant risk factor for the development of BG.

• #20 Bile Reflux: Symptoms, Treatment, Causes & What It Is

  https://my.clevelandclinic.org/health/diseases/22056-bile-reflux

  Bile reflux is not thought to be common in otherwise healthy individuals. […] Bile reflux is most commonly recognized as a complication of surgery, particularly stomach surgery that bypasses, damages or replaces the pyloric valve. […] Bile (or non-acid) reflux is not common, but its a known complication of certain surgeries.

• #21

  https://link.springer.com/article/10.1023/A:1021069508731

  Duodenogastric reflux (DGR) was assessed with 24-hour gastric bilirubin monitoring in 345 patients (219 men; 49 13 years) with foregut symptoms and 41 healthy subjects (24 men, 28 5 years). […] DGR was highest following Billroth II gastric resection (60 24%, N = 15). Patients after cholecystectomy (28 25%, N = 25), patients with gastroesophageal reflux disease (24 24%, N = 199), and patients with nonulcer dyspepsia (23 21%, N = 61) had a significantly higher exposure to DGR than healthy subjects (7 8%, P 0.0001). […] In conclusion, gastric bilirubin monitoring is useful for the assessment of DGR specifically in symptomatic patients following gastric resection. Increased amounts of DGR may further be of clinical importance in patients with reflux disease or nonulcer dyspepsia and following cholecystectomy.

• #22 Biliary reflux after bariatric surgery and after gastroesophageal surgery for gastroesophageal reflux disease – Marabotto – Digestive Medicine Research

  https://dmr.amegroups.org/article/view/9258/html

  Biliary reflux refers to the ascent of duodenal fluid, biliary and pancreatic secretions into the stomach and esophagus. It is a primitive phenomenon or it can be secondary to gastric or biliary surgery. In particular, biliary reflux seems common after bariatric surgeries with, however, unknown incidence. Current data show that the prevalence of biliary reflux was higher after minigastric bypass as compared to the other bariatric surgeries. […] The prevalence of biliary reflux after bariatric surgeries has been heterogeneously reported in a number of studies. Lasheen et al. assessed the prevalence of bile reflux gastritis and esophagitis in over 40 patients after MGB and found that 20% of them had bile reflux as diagnosed by gastric pouch biopsy and gastric aspirate examination. […] The reported prevalence of biliary reflux was higher after MGB as compared to the other bariatric surgeries and when HIDA was used to measure biliary reflux as compared to endoscopy and gastric pouch biopsies.

• #23 Biliary reflux after bariatric surgery and after gastroesophageal surgery for gastroesophageal reflux disease – Marabotto – Digestive Medicine Research

  https://dmr.amegroups.org/article/view/9258/html

  Biliary reflux refers to the ascent of duodenal fluid, biliary and pancreatic secretions into the stomach and esophagus. It is a primitive phenomenon or it can be secondary to gastric or biliary surgery. In particular, biliary reflux seems common after bariatric surgeries with, however, unknown incidence. Current data show that the prevalence of biliary reflux was higher after minigastric bypass as compared to the other bariatric surgeries. […] The prevalence of biliary reflux after bariatric surgeries has been heterogeneously reported in a number of studies. Lasheen et al. assessed the prevalence of bile reflux gastritis and esophagitis in over 40 patients after MGB and found that 20% of them had bile reflux as diagnosed by gastric pouch biopsy and gastric aspirate examination. […] The reported prevalence of biliary reflux was higher after MGB as compared to the other bariatric surgeries and when HIDA was used to measure biliary reflux as compared to endoscopy and gastric pouch biopsies.

• #24 Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=09608923&AN=156152475&h=2GJSF1PJyF73OrmExRmYCU%2BoFWw%2BjcMGvN%2BzHbLqzHqmgzAxks37ppS5Hp6Rsr8U54CuaRl3y9HmsOarH0GluA%3D%3D&crl=c

  Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery. […] Purpose: Excellent metabolic improvement following one anastomosis gastric bypass (OAGB) remains compromised by the risk of esophageal bile reflux and theoretical carcinogenic potential. […] No 'gold standard’ investigation exists for esophageal bile reflux, with diverse methods employed in the few studies evaluating it post-obesity surgery. […] As such, data on the incidence and severity of esophageal bile reflux is limited, with comparative studies lacking. […] Results: Gastric reflux of bile was identified by biliary scintigraphy in 14 OAGB (70%), one RYGB (5%) and four SG participants (31%), with a mean of 2.9% (SD 1.5) reflux (% of total radioactivity). […] One participant (OAGB) demonstrated esophageal bile reflux. […] Conclusion: Despite high incidence of gastric bile reflux post-OAGB, esophageal bile reflux is rare. […] With scarce literature of tumour development post-OAGB, frequent low-volume gastric bile reflux likely bears little clinical consequence; however, longer-term studies are needed.

• #25 Bile Reflux following Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) and its Surgical Treatment : Bariatric Times

  https://bariatrictimes.com/bile-reflux-sadis-surgical-treatment/

  Bile reflux following the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) procedure is rare. The reported incidence of bile reflux following the SADI-S procedure is 0.1 percent. […] Bile reflux can occur months to years after SADI-S. If it occurs, it can be fixed easily with surgical treatment.

• #26 Gastroesophageal Reflux Disease: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/176595-overview

  Western dietary habits have made GERD a common disease. The prevalence of GERD in Western populations is estimated to be 10-20%, whereas it is about 2.5-17.0% in Asian populations. […] Richter and associates reported that 25%-40% of Americans experience symptomatic GERD at some point. Approximately 7%-10% of Americans experience symptoms of GERD on a daily basis. Because many individuals control their symptoms with over-the-counter (OTC) medications and without consulting a medical professional, the actual number of individuals with GERD is probably higher. […] No sexual predilection exists: GERD is as common in men as in women. However, the male-to-female incidence ratio for esophagitis is 2:1-3:1. The male-to-female incidence ratio for Barrett esophagus is 10:1. White males are at a greater risk for Barrett esophagus and adenocarcinoma than other populations. […] GERD occurs in all age groups. The prevalence of GERD increases in people older than 40 years.

• #27 Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review | Gut

  https://gut.bmj.com/content/63/6/871

  Objective To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD). […] Results 16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%27.8% in North America, 8.8%25.9% in Europe, 2.5%7.8% in East Asia, 8.7%33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 117years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p0.0001), particularly in North America and East Asia. […] Conclusions GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%.

• #28 Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review | Gut

  https://gut.bmj.com/content/63/6/871

  Objective To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD). […] Results 16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%27.8% in North America, 8.8%25.9% in Europe, 2.5%7.8% in East Asia, 8.7%33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 117years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p0.0001), particularly in North America and East Asia. […] Conclusions GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%.

• #29 Management of Bile Reflux – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/march-2013/management-of-bile-reflux/

  Bile reflux is very infrequent in healthy individuals. This condition is more severe in patients with gastroesophageal reflux disease, particularly those with severe esophagitis and/or Barrett esophagus. […] It has been shown that patients with more bile reflux have more severe esophageal mucosal damage, so there is a clear correlation between the amount of bile reflux and the severity of distal esophageal inflammation. In fact, patients with the most severe degree of gastroesophageal inflammation, Barrett esophagus, are those with the largest amount of bile reflux. Thus, the importance of bile reflux has to do primarily with the severity of the damage of the esophageal mucosa, the development of Barrett mucosa, and, potentially, the risk of cancer. It is known that the more bile reflux a patient has, the higher the risk of Barrett esophagus development; both in vivo and in vitro studies have shown a link between bile that is in contact with esophageal mucosa and changes in the mucosa that are compatible with Barrett esophagus.

• #30 Management of Bile Reflux – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/march-2013/management-of-bile-reflux/

  Bile reflux is very infrequent in healthy individuals. This condition is more severe in patients with gastroesophageal reflux disease, particularly those with severe esophagitis and/or Barrett esophagus. […] It has been shown that patients with more bile reflux have more severe esophageal mucosal damage, so there is a clear correlation between the amount of bile reflux and the severity of distal esophageal inflammation. In fact, patients with the most severe degree of gastroesophageal inflammation, Barrett esophagus, are those with the largest amount of bile reflux. Thus, the importance of bile reflux has to do primarily with the severity of the damage of the esophageal mucosa, the development of Barrett mucosa, and, potentially, the risk of cancer. It is known that the more bile reflux a patient has, the higher the risk of Barrett esophagus development; both in vivo and in vitro studies have shown a link between bile that is in contact with esophageal mucosa and changes in the mucosa that are compatible with Barrett esophagus.

• #31 Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2653330/

  AIM: To determine the prevalence and characteristics of bile reflux in gastroesophageal reflux disease (GERD) patients with persistent symptoms who are non-responsive to medical therapy. […] The overall prevalence of bile reflux in non-responsive patients was 68.7%. […] Our findings also showed that a high percentage of GERD patients poorly responsive to PPIs have biliary reflux. We found that a high percentage (53.3%) of non-esophagitic GERD patients had pathologic bile reflux, increasing to 70% in esophagitic patients. […] This study clearly shows that the high percentage of patients poorly responsive to PPI therapy may result from poor control of DGERD. Many patients without esophagitis have simultaneous acid and bile reflux, which increases with increasing esophagitis grade.

• #32 Bile Reflux: Clinical Considerations – Gastroenterology Advisor

  https://www.gastroenterologyadvisor.com/features/tips-for-distinguishing-and-treating-biliary-reflux/

  Certain patients may develop biliary reflux based on having an acid-bile pocket in the proximal part of the stomach; this leads to a collection of bile and may predispose the patient to esophageal reflux. […] Identification of biliary reflux is important, as patients experiencing this can have more severe mucosal damage in the esophagus, including BE. […] A study conducted by Dixon et al found that patients with BE had more evidence of bile related gastritis compared with those reported as having only GERD or nonulcer dyspepsia. […] This study, along with others, raises the question as to whether there is a carcinogenic role of bile reflux. […] Therefore, patients with evidence of bile reflux should be considered for more aggressive therapy, in the hopes of potentially preventing negative sequelae such as BE. […] The authors concluded that duodeno-gastric bile reflux was present in at least 1/3 of patients with functional dyspepsia.

• #33 Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2653330/

  AIM: To determine the prevalence and characteristics of bile reflux in gastroesophageal reflux disease (GERD) patients with persistent symptoms who are non-responsive to medical therapy. […] The overall prevalence of bile reflux in non-responsive patients was 68.7%. […] Our findings also showed that a high percentage of GERD patients poorly responsive to PPIs have biliary reflux. We found that a high percentage (53.3%) of non-esophagitic GERD patients had pathologic bile reflux, increasing to 70% in esophagitic patients. […] This study clearly shows that the high percentage of patients poorly responsive to PPI therapy may result from poor control of DGERD. Many patients without esophagitis have simultaneous acid and bile reflux, which increases with increasing esophagitis grade.

• #34 Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

  https://www.wjgnet.com/1007-9327/full/v15/i3/334.htm

  Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors. […] The high percentage of patients poorly responsive to PPI therapy may result from poor control of duodenogastroesophageal reflux. […] Many patients without esophagitis have simultaneous acid and bile reflux, which increases with increasing esophagitis grade. […] A high percentage of GERD patients poorly responsive to PPIs have biliary reflux. […] The global prevalence of patients non-responsive to PPI therapy was 68.7%.

• #35 Prevalence of bile reflux in gastroesophageal reflux disease patients not responsive to proton pump inhibitors

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2653330/

  AIM: To determine the prevalence and characteristics of bile reflux in gastroesophageal reflux disease (GERD) patients with persistent symptoms who are non-responsive to medical therapy. […] The overall prevalence of bile reflux in non-responsive patients was 68.7%. […] Our findings also showed that a high percentage of GERD patients poorly responsive to PPIs have biliary reflux. We found that a high percentage (53.3%) of non-esophagitic GERD patients had pathologic bile reflux, increasing to 70% in esophagitic patients. […] This study clearly shows that the high percentage of patients poorly responsive to PPI therapy may result from poor control of DGERD. Many patients without esophagitis have simultaneous acid and bile reflux, which increases with increasing esophagitis grade.

• #36 Approach to refractory gastroesophageal reflux disease in adults – UpToDate

  https://www.uptodate.com/contents/approach-to-refractory-gastroesophageal-reflux-disease-in-adults

  Up to 50 percent of patients with gastroesophageal reflux disease (GERD) fail to respond symptomatically, either partially or completely, to proton pump inhibitors (PPIs) [3-7]. Most patients with GERD who do not respond to a PPI have either nonerosive reflux (NERD) or functional heartburn. In patients with NERD, the pooled symptomatic response rate to PPI once daily at four weeks is 37 percent [8,9]. In contrast, in patients with erosive esophagitis, which accounts for 30 to 40 percent of the GERD population, the pooled symptomatic response rate is 56 percent [8].

• #37 Approach to refractory gastroesophageal reflux disease in adults – UpToDate

  https://www.uptodate.com/contents/approach-to-refractory-gastroesophageal-reflux-disease-in-adults

  Up to 50 percent of patients with gastroesophageal reflux disease (GERD) fail to respond symptomatically, either partially or completely, to proton pump inhibitors (PPIs) [3-7]. Most patients with GERD who do not respond to a PPI have either nonerosive reflux (NERD) or functional heartburn. In patients with NERD, the pooled symptomatic response rate to PPI once daily at four weeks is 37 percent [8,9]. In contrast, in patients with erosive esophagitis, which accounts for 30 to 40 percent of the GERD population, the pooled symptomatic response rate is 56 percent [8].

• #38 Biliary reflux – Wikipedia

  https://en.wikipedia.org/wiki/Biliary_reflux

  Bile reflux is very infrequent in healthy individuals. […] Bile acids are frequently present in the gastroesophageal refluxate, and thus can cause inflammatory and neoplastic changes in the upper aerodigestive tract. […] Bile reflux appears to be a causal factor in human hypopharyngeal squamous cell carcinoma.

• #39 Management of Bile Reflux – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/march-2013/management-of-bile-reflux/

  However, there is no need for patients with bile reflux to undergo special monitoring or take any prophylactic measures (apart from treatment of gastroesophageal reflux disease) unless they already have Barrett esophagus. Even in this case, endoscopic surveillance is controversial if the Barrett mucosa shows no signs of dysplasia. […] There are 3 main lines of research in this area. One is related to the impact of bile acids and bile salts in the esophageal mucosa and the development of Barrett esophagus and cancer. The second line of research involves the role of bile reflux in extraesophageal syndromes related to reflux (eg, the development of respiratory disorders associated with reflux). There is some evidence that the presence of bile in the aspiration of refluxate into the airways might be very important in the development of respiratory disorders. This is a marker of aspiration as well as a very important inflammatory component that can trigger inflammation. This is true for patients with reflux who have undergone lung transplantation and patients with cystic fibrosis. Thus, the appearance of bile in respiratory secretions is not only considered a marker, but it can also be pathogenic in the respiratory disorder. The third line of research involves the role of bile in the pathogenesis of nonerosive reflux disease and symptoms. It is known that patients who have persistent symptoms such as heartburn or regurgitation may have refluxate that contains bile acid despite receiving proton pump inhibitor therapy (because proton pump inhibitors do not reduce the presence of bile acid). Bile acids might have an impact on the esophageal mucosa of patients with nonerosive reflux disease and might be related to the persistence of symptoms in these patients.

• #40 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Nowadays, as a kind of gastrointestinal disorders, BRG is deemed as a risk factor for gastric cancer but not taken seriously in gastroenterology department. […] More and more studies have established that bile reflux gastritis is closely associated with the development of precancerous lesions and gastric cancer (GC) and may be an independent risk factor for GC. A multicenter, cross-sectional, and observational study conducted in five centers in China concluded that independent risk factors for cancerous gastric lesions were the grade of bile reflux, patient’s age, dietary habits, and family history of GC. […] The mechanism of GC induced by bile reflux is still unclear. […] The diagnosis of bile reflux gastritis is still challenging for its atypical clinical symptoms and nonspecific auxiliary examinations.

• #41 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Nowadays, as a kind of gastrointestinal disorders, BRG is deemed as a risk factor for gastric cancer but not taken seriously in gastroenterology department. […] More and more studies have established that bile reflux gastritis is closely associated with the development of precancerous lesions and gastric cancer (GC) and may be an independent risk factor for GC. A multicenter, cross-sectional, and observational study conducted in five centers in China concluded that independent risk factors for cancerous gastric lesions were the grade of bile reflux, patient’s age, dietary habits, and family history of GC. […] The mechanism of GC induced by bile reflux is still unclear. […] The diagnosis of bile reflux gastritis is still challenging for its atypical clinical symptoms and nonspecific auxiliary examinations.

• #42 Medical management of acid/bile reflux before, during and after endoscopic therapy for Barrett’s esophagus: a narrative review – Jaswani – Annals of Esophagus

  https://aoe.amegroups.org/article/view/5859/html

  Bile reflux or duodenogastric reflux has been proposed in the etiology of BE as bile acids have been found in the refluxate of patients with BE. It has been suggested that bile acids may exert their effects on the esophageal mucosa through cytotoxic pathways and upregulation of proto-oncogene and c-myc resulting in inflammation and contributing to the inflammation-cancer cascade. Bile acids become non- ionized at acidic pH, enters cells and exert mucosal injury and inflammation. The effect of bile acid has been found to be most significant when combined with gastric acid. […] Inadequate acid suppression defined by impedance-pH monitoring is a modifiable risk factor and increases the risk of recurrence of intestinal metaplasia (IM) after EET. Ongoing distal esophageal reflux, both acid and non-acid is also associated with incomplete response to EET. This observation highlights the importance of aggressive pharmacologic acid suppression and also reminds us of the role of lifestyle modifications in decreasing distal esophageal reflux exposure both during and after the EET period.

• #43 Screening for Bile Reflux Could Help Identify Barrett Esophagus

  https://www.gastroenterologyadvisor.com/news/screening-for-bile-reflux-could-help-identify-barrett-esophagus/

  Endoscopic evidence of bile reflux could serve as a predictor of Barrett esophagus development. […] Endoscopic evidence of bile reflux is associated with the presence of Barrett esophagus (BE), according to a study published in Digestive and Liver Disease. […] This endoscopic finding might therefore help identify patients at risk of developing BE and would benefit endoscopy surveillance. […] Evidence of bile reflux was associated with the presence of BE (OR, 5.65; 95% CI, 4.71-6.76; P .001). […] The researchers concluded, This endoscopic finding might, therefore, help identify patients at risk of developing BE and would benefit endoscopy surveillance.

• #44 Medical management of acid/bile reflux before, during and after endoscopic therapy for Barrett’s esophagus: a narrative review – Jaswani – Annals of Esophagus

  https://aoe.amegroups.org/article/view/5859/html

  Bile reflux or duodenogastric reflux has been proposed in the etiology of BE as bile acids have been found in the refluxate of patients with BE. It has been suggested that bile acids may exert their effects on the esophageal mucosa through cytotoxic pathways and upregulation of proto-oncogene and c-myc resulting in inflammation and contributing to the inflammation-cancer cascade. Bile acids become non- ionized at acidic pH, enters cells and exert mucosal injury and inflammation. The effect of bile acid has been found to be most significant when combined with gastric acid. […] Inadequate acid suppression defined by impedance-pH monitoring is a modifiable risk factor and increases the risk of recurrence of intestinal metaplasia (IM) after EET. Ongoing distal esophageal reflux, both acid and non-acid is also associated with incomplete response to EET. This observation highlights the importance of aggressive pharmacologic acid suppression and also reminds us of the role of lifestyle modifications in decreasing distal esophageal reflux exposure both during and after the EET period.

• #45 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  The growing epidemic of obesity and the increase in weight loss surgery has led to a resurgence of interest in biliary reflux because anatomical alterations may be refluxogenic. […] HIDA scan is the least invasive scan with good patient tolerability, sensitivity and reproducibility for the diagnosis of biliary reflux. […] Patients with more advanced oesophageal lesions have a higher degree of duodenal reflux. It has been shown in animal models and in vitro that there is more Barrett’s and dysplasia with duodenal reflux. […] Prospective trials on OAGB should include endoscopy preoperatively and at 5-year intervals, to have data on the real effects of bile exposure on the gastric reservoir and oesophagus. […] In the latest systematic review analysing the prevalence, symptoms, lesions and treatment of DGOR, several studies both in vitro and in vivo have implicated duodenal contents in the pathogenesis of oesophagogastric lesions.

• #46 Roles and action mechanisms of bile acid-induced gastric intestinal metaplasia: a review | Cell Death Discovery

  https://www.nature.com/articles/s41420-022-00962-1

  Long-term exposure to bile acids has been shown to increase the risk of transition from normal mucosa to IM, and eventually leads to the development of GC over many years. […] However, there are no clear studies on whether bile-reflux monitoring can be used to monitor and delay the development of gastric IM. […] Currently, there is a controversial debate whether or not gastric IM is reversible. […] It is generally believed that H. pylori eradication before the occurrence of gastric IM can help control gastritis, while once gastric IM is established, H. pylori eradication cannot reverse gastric IM but can help prevent or delay the progression of gastric IM. […] Therefore, more evidence is needed to determine whether H. pylori eradication can delay and reverse IM. […] In summary, the symptoms caused by bile reflux can be alleviated by drugs and surgery. However, there are no high-quality studies on whether the treatment of bile reflux can reverse IM.

• #47 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  Recent trials that have attempted to directly treat bile as a component of gastro-oesophageal reflux disease (GORD) have demonstrated an improvement in symptoms and lesions in these patients. […] A new therapy, called IW-3718 (Colesevelam), binds and neutralises bile in the stomach, decreasing the volume of reflux and improving endoscopic imaging in 87% of cases, while also increasing muscle tissue relaxation. […] Despite the known histopathological links between oesophageal mucosal exposure to bile and carcinogenesis, only two cases of gastric pouch/distal oesophageal malignancy have been described in 20 years since the advent of OAGB. […] These results suggest that prospective trials of OAGB should include endoscopy preoperatively and at 5-year intervals to provide data on the true effects of bile exposure in the gastric reservoir and oesophagus. […] The HIDA scan is a sensitive measure of remnant pathology and is a readily available non-invasive test.

• #48 Biliary reflux – Wikipedia

  https://en.wikipedia.org/wiki/Biliary_reflux

  Bile reflux is very infrequent in healthy individuals. […] Bile acids are frequently present in the gastroesophageal refluxate, and thus can cause inflammatory and neoplastic changes in the upper aerodigestive tract. […] Bile reflux appears to be a causal factor in human hypopharyngeal squamous cell carcinoma.

• #49 Bile reflux and hypopharyngeal cancer (Review)

  https://www.spandidos-publications.com/10.3892/or.2021.8195

  Recent in vitro and in vivo data provide evidence on bile reflux-associated hypopharyngeal carcinogenesis. […] In parallel, acidic bile-induced constitutive activation of NF-B can promote oncogenic mRNA and miRNA phenotypes, contributing to the proliferation of mutated cells and thus giving rise to the malignant transformation of the exposed HM.

• #50 Mayo Clinic Health Library – Bile reflux | Swiss Medical Network

  https://www.swissmedical.net/fr/healtcare-library/con-20370100

  Bile reflux occurs when bile a digestive liquid produced in your liver backs up (refluxes) into your stomach and, in some cases, into the tube that connects your mouth and stomach (esophagus). […] Bile reflux may accompany the reflux of stomach acid (gastric acid) into your esophagus. Gastric reflux may lead to gastroesophageal reflux disease (GERD), a potentially serious problem that causes irritation and inflammation of esophageal tissue. […] Bile reflux gastritis has been linked to stomach cancer. The combination of bile reflux and acid reflux also increases the risk of the following complications: […] Bile is often suspected of contributing to GERD when people respond incompletely or not at all to powerful acid-suppressant medications. […] In animal studies, bile reflux alone has been shown to cause cancer of the esophagus.

• #51 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Nowadays, as a kind of gastrointestinal disorders, BRG is deemed as a risk factor for gastric cancer but not taken seriously in gastroenterology department. […] More and more studies have established that bile reflux gastritis is closely associated with the development of precancerous lesions and gastric cancer (GC) and may be an independent risk factor for GC. A multicenter, cross-sectional, and observational study conducted in five centers in China concluded that independent risk factors for cancerous gastric lesions were the grade of bile reflux, patient’s age, dietary habits, and family history of GC. […] The mechanism of GC induced by bile reflux is still unclear. […] The diagnosis of bile reflux gastritis is still challenging for its atypical clinical symptoms and nonspecific auxiliary examinations.

• #52 Roles and action mechanisms of bile acid-induced gastric intestinal metaplasia: a review | Cell Death Discovery

  https://www.nature.com/articles/s41420-022-00962-1

  Gastric intestinal metaplasia (IM) is a precancerous lesion that increases the risk of subsequent gastric cancer (GC) development. […] However, more and more studies have shown that chronic inflammation of gastric mucosa caused by bile reflux is the key pathogenic factor of gastric IM. […] Accumulative evidence has revealed that bile reflux is associated with gastric IM and even carcinoma. […] Bile reflux into the stomach can not only directly stimulate the gastric mucosal barrier, but also regulate multiple downstream pathways to induce chronic inflammation of the gastric mucosa. […] Increasing evidence has demonstrated that bile reflux is thought to be associated with atrophic gastritis, IM, dysplasia, and even carcinogenesis. […] The mechanism of bile acid-induced gastric IM in the stomach is not clear and needs further research.

• #53 Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review | Gut

  https://gut.bmj.com/content/63/6/871

  Objective To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD). […] Results 16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%27.8% in North America, 8.8%25.9% in Europe, 2.5%7.8% in East Asia, 8.7%33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 117years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p0.0001), particularly in North America and East Asia. […] Conclusions GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%.

• #54 Reflux Esophagitis Pathology: Definition, Epidemiology, Etiology

  https://emedicine.medscape.com/article/1610393-overview

  GERD is prevalent worldwide. In the United States, studies have shown that approximately 18.1-27.8% of the population experiences GERD symptoms, which is consistent with other Western countries. […] Globally, the prevalence of GERD varies significantly, ranging from 2.5% to 7.8% in East Asia, 8.8% to 25.9% in Europe, and 8.7% to 33.1% in the Middle East. […] The global age-standardized prevalence rate of GERD has remained relatively stable, with an estimated 9574.45 per 100,000 population in 2019. […] Racial and ethnic differences in the prevalence of reflux esophagitis are also well reported in the literature. Studies from the United States and Europe show that White individuals have a higher prevalence of severe grades of esophagitis and Barrett’s esophagus (a complication of GERD) relative to Hispanics, Blacks, and Asians.

• #55 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Although gastro-oesophageal reflux disease (GORD) is a common medical complaint, there is currently no consensus on the global prevalence of GORD. […] The global pooled prevalence of GORD was 13.98% and varied greatly according to region (12.88% in Latin America and the Caribbean to 19.55% in North America) and country (4.16% in China to 22.40% in Turkey). […] Using the United Nations 2017 Revision of World Population Prospects, the estimated number of individuals suffering from GORD globally is 1.03 billion. […] This systematic review and meta-analysis revealed that although a substantial proportion (13.98%) of the global population suffers from GORD, there are significant variations between regions and countries. […] A recent systematic review and meta-analysis conducted by Eusebi et al. 2017 included 108 studies and assessed the global prevalence of, and risk factors for, gastric reflux symptoms rather the prevalence of GORD.

• #56 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Subjects with a moderate/high intake of carbonated drinks had a higher pooled prevalence of GORD than those with low/none intake (18.60% vs 14.54%, respectively). […] Pooling prevalence of GORD according to intake of coffee/tea revealed a higher GORD prevalence in subjects with a moderate/high intake of coffee/tea (21.02%) than those with a low/none intake (16.92%). […] This comprehensive systematic review has demonstrated the significant global burden of GORD with approximately 1.03 billion individuals suffering from the condition globally. […] It has also confirmed substantial variations in the pooled prevalence of GORD between regions and countries.

• #57 Epidemiology of gastroesophageal reflux disease in Iran: a systematic review and meta-analysis | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-020-01417-6

  A systematic review of longitudinal studies suggests that the incidence of GERD has increased in recent decades. If this trend continues, it may rapidly increase the serious complications of GERD, affect the patients quality of life, and increase the cost of health care systems. […] Increasing the GERD awareness to improve Iranian peoples health may be necessary. There is much information in Western cultures that can be generalized to an Iranian person but cannot match completely. Therefore, understanding the epidemiological effects of GERD in Iranian society can help healthcare professionals and policymakers take the next steps in creating the list of priorities for disease management.

• #58 The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm18140

  Gastroesophageal reflux disease (GERD) is a common disease globally with increasing prevalence and consequently greater burden on the Healthcare system. […] Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years. […] The increase in GERD prevalence may be due to multiple factors such as older age, male sex, race, intake of analgesics, consumption of certain types of food and drinks, decrease in the prevalence of Helicobacter pylori infection, smoking, family history of GERD, high body mass index (BMI), and limited physical activity. […] As risk factors for GERD increasingly affect the general population, concerns have been raised that more young individuals will develop GERD and its potential consequences.

• #59 The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm18140

  Gastroesophageal reflux disease (GERD) is a common disease globally with increasing prevalence and consequently greater burden on the Healthcare system. […] Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years. […] The increase in GERD prevalence may be due to multiple factors such as older age, male sex, race, intake of analgesics, consumption of certain types of food and drinks, decrease in the prevalence of Helicobacter pylori infection, smoking, family history of GERD, high body mass index (BMI), and limited physical activity. […] As risk factors for GERD increasingly affect the general population, concerns have been raised that more young individuals will develop GERD and its potential consequences.

• #60 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1058566

  Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. […] Endoscopic bile reflux was common findings with young adults (30’s) at outpatients clinic. […] Bile reflux also had distinguishable ultra-structural changes identifiable by EM. […] GB dysfunction were identified as significant risk factors for BRI (+) group. […] The BRI (+) group had more old age, GB dysfunction than BRI (-) group. […] The BRI (+) group correlated with GB dysfunction (OR, 2.41; 95% CI, 0.62 to 9.31). […] Endoscopic bile reflux (9.7%) is a very common disease encountered in the outpatients clinic. It was found to be common in young adults (30’s) and more predominant in females. […] Bile reflux inhibited colonization of H. pylori in the stomach. […] BRI (+) group had more old age and GB dysfunction than BRI (-) group.

• #61 Cited

  https://www.koreamed.org/SearchBasic.php?RID=2284011&DT=1

  Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. […] Endoscopic bile reflux was common findings with young adults (30’s) at outpatients clinic. […] GB dysfunction were identified as significant risk factors for BRI (+) group.

• #62 The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm18140

  Our study showed that the proportion of patients with GERD has increased in all age groups, with the exception of those who were aged 70 years in both the universal and Healthcare system datasets. […] In our study, however, the greatest rise in the proportion of patients with GERD diagnosis was seen in young adults aged 30-39 years in both datasets during the last decade. […] An important finding of our study was the general characteristic of GERD patients who were primarily obese or severely obese, older women, and Caucasian. […] Our study suggests that physicians should be more aware that the proportion of young adults with GERD has been increasing continuously.

• #63 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Although there is no golden standard for diagnosis of BRG, four vital techniques including hepatobiliary scintigraphy, gastroscopy with aspiration of gastric juice, fiberoptic bilirubin monitoring, and esophageal impedance-pH testing are commonly recognized. […] To date, there is still no official and unified therapeutic regimen for patients with BRG.

• #64 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Although there is no golden standard for diagnosis of BRG, four vital techniques including hepatobiliary scintigraphy, gastroscopy with aspiration of gastric juice, fiberoptic bilirubin monitoring, and esophageal impedance-pH testing are commonly recognized. […] To date, there is still no official and unified therapeutic regimen for patients with BRG.

• #65 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  Recent trials that have attempted to directly treat bile as a component of gastro-oesophageal reflux disease (GORD) have demonstrated an improvement in symptoms and lesions in these patients. […] A new therapy, called IW-3718 (Colesevelam), binds and neutralises bile in the stomach, decreasing the volume of reflux and improving endoscopic imaging in 87% of cases, while also increasing muscle tissue relaxation. […] Despite the known histopathological links between oesophageal mucosal exposure to bile and carcinogenesis, only two cases of gastric pouch/distal oesophageal malignancy have been described in 20 years since the advent of OAGB. […] These results suggest that prospective trials of OAGB should include endoscopy preoperatively and at 5-year intervals to provide data on the true effects of bile exposure in the gastric reservoir and oesophagus. […] The HIDA scan is a sensitive measure of remnant pathology and is a readily available non-invasive test.

• #66 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  The growing epidemic of obesity and the increase in weight loss surgery has led to a resurgence of interest in biliary reflux because anatomical alterations may be refluxogenic. […] HIDA scan is the least invasive scan with good patient tolerability, sensitivity and reproducibility for the diagnosis of biliary reflux. […] Patients with more advanced oesophageal lesions have a higher degree of duodenal reflux. It has been shown in animal models and in vitro that there is more Barrett’s and dysplasia with duodenal reflux. […] Prospective trials on OAGB should include endoscopy preoperatively and at 5-year intervals, to have data on the real effects of bile exposure on the gastric reservoir and oesophagus. […] In the latest systematic review analysing the prevalence, symptoms, lesions and treatment of DGOR, several studies both in vitro and in vivo have implicated duodenal contents in the pathogenesis of oesophagogastric lesions.

• #67 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  Recent trials that have attempted to directly treat bile as a component of gastro-oesophageal reflux disease (GORD) have demonstrated an improvement in symptoms and lesions in these patients. […] A new therapy, called IW-3718 (Colesevelam), binds and neutralises bile in the stomach, decreasing the volume of reflux and improving endoscopic imaging in 87% of cases, while also increasing muscle tissue relaxation. […] Despite the known histopathological links between oesophageal mucosal exposure to bile and carcinogenesis, only two cases of gastric pouch/distal oesophageal malignancy have been described in 20 years since the advent of OAGB. […] These results suggest that prospective trials of OAGB should include endoscopy preoperatively and at 5-year intervals to provide data on the true effects of bile exposure in the gastric reservoir and oesophagus. […] The HIDA scan is a sensitive measure of remnant pathology and is a readily available non-invasive test.

• #68

  https://journals.lww.com/jcat/fulltext/2017/09000/correlation_between_bile_reflux_gastritis_and.5.aspx

  This study aimed to evaluate the relationship between biliary excreted contrast media in the stomach and the presence of bile reflux gastritis. […] Biliary excreted contrast media in the stomach on 60-minute delayed gadoxetic MRC has a correlation with the presence of bile reflux gastritis on endoscopic examination. […] Bile reflux gastritis was significantly more common in patients with contrast media in the stomach on gadoxetic MRC (13/39 [33.3%]) than in those without contrast media (0/72 [0%]; P 0.001). […] The result of the linear-by-linear association revealed that patients with high-grade extension of contrast media in the stomach had significantly frequent bile reflux gastritis than did those with low-grade extension. […] Our study shows the applicability of MRI using hepatocyte-specific contrast media in detecting bile reflux.

• #69

  https://journals.lww.com/jcat/fulltext/2017/09000/correlation_between_bile_reflux_gastritis_and.5.aspx

  This study aimed to evaluate the relationship between biliary excreted contrast media in the stomach and the presence of bile reflux gastritis. […] Biliary excreted contrast media in the stomach on 60-minute delayed gadoxetic MRC has a correlation with the presence of bile reflux gastritis on endoscopic examination. […] Bile reflux gastritis was significantly more common in patients with contrast media in the stomach on gadoxetic MRC (13/39 [33.3%]) than in those without contrast media (0/72 [0%]; P 0.001). […] The result of the linear-by-linear association revealed that patients with high-grade extension of contrast media in the stomach had significantly frequent bile reflux gastritis than did those with low-grade extension. […] Our study shows the applicability of MRI using hepatocyte-specific contrast media in detecting bile reflux.

• #70

  https://journals.lww.com/jcat/fulltext/2017/09000/correlation_between_bile_reflux_gastritis_and.5.aspx

  Therefore, we suggest that the sensitivity of gadoxetic acidenhanced MRI is superior to that of gastroscopy in the diagnosis of bile reflux gastritis. […] In conclusion, biliary excreted contrast media in the stomach suggests duodenogastric bile reflux, and one third of the patients who showed contrast media in the stomach had bile reflux gastritis. The benefit of gadoxetic MRC is that it shows very high specificity to predict the presence of bile reflux gastritis. Moreover, the amount of reflux contrast media was significantly correlated with the presence of bile reflux gastritis.

• #71

  https://link.springer.com/article/10.1023/A:1024130419914

  To avoid food impaction artifacts during ambulatory bile reflux monitoring (Bilitec), some groups have allowed only a liquid diet, while others omitted the meal and postprandial periods from the analysis. […] Thus, ambulatory Bilitec monitoring requires the use of liquid meals, as the use of solid meals is associated with too many meal artifacts and a poorer correlation with acid reflux and severity of endoscopic lesions.

• #72 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Subjects with a moderate/high intake of carbonated drinks had a higher pooled prevalence of GORD than those with low/none intake (18.60% vs 14.54%, respectively). […] Pooling prevalence of GORD according to intake of coffee/tea revealed a higher GORD prevalence in subjects with a moderate/high intake of coffee/tea (21.02%) than those with a low/none intake (16.92%). […] This comprehensive systematic review has demonstrated the significant global burden of GORD with approximately 1.03 billion individuals suffering from the condition globally. […] It has also confirmed substantial variations in the pooled prevalence of GORD between regions and countries.

• #73 The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm18140

  Gastroesophageal reflux disease (GERD) is a common disease globally with increasing prevalence and consequently greater burden on the Healthcare system. […] Over the last decade, there has been a significant increase in the proportion of younger patients with GERD, especially those within the age range of 30-39 years. […] The increase in GERD prevalence may be due to multiple factors such as older age, male sex, race, intake of analgesics, consumption of certain types of food and drinks, decrease in the prevalence of Helicobacter pylori infection, smoking, family history of GERD, high body mass index (BMI), and limited physical activity. […] As risk factors for GERD increasingly affect the general population, concerns have been raised that more young individuals will develop GERD and its potential consequences.

• #74 Reflux – Acid or Bile? Know the difference | Gastrointestinal Associates

  https://gihealthcare.com/reflux-acid-or-bile-know-the-difference/

  Bile reflux may occur in conjunction with GERD or may be misdiagnosed as GERD because the symptoms of the two conditions are very similar. […] Like GERD, identifying and treating bile reflux is important. When left untreated it can result in serious, sometimes life-threatening problems, such as esophageal ulcers that bleed and Barretts esophagus, a condition in which the cells in the lining of the esophagus transform into tissue similar to the type that lines the stomach. […] Bile reflux is common in individuals who have had surgery to remove their gallbladder or those who have undergone gastric surgery, including a total or partial removal of the stomach (gastrectomy) or gastric bypass surgery for weight loss. It also is common in patients with peptic ulcers. […] Because the symptoms of acid reflux and bile reflux are so similar, it is impossible to make a diagnosis of bile reflux based on symptoms alone.

• #75 Gastroesophageal reflux disease – Wikipedia

  https://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease

  In Western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. For instance, an estimated 3.4 million to 6.8 million Canadians have GERD. The prevalence rate of GERD in developed nations is also tightly linked with age, with adults aged 60 to 70 being the most commonly affected. In the United States 20% of people have symptoms in a given week and 7% every day. […] No data supports sex predominance with regard to GERD.

• #76 Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review | Gut

  https://gut.bmj.com/content/63/6/871

  Objective To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD). […] Results 16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%27.8% in North America, 8.8%25.9% in Europe, 2.5%7.8% in East Asia, 8.7%33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 117years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p0.0001), particularly in North America and East Asia. […] Conclusions GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%.

• #77 Epidemiology of gastroesophageal reflux disease in Iran: a systematic review and meta-analysis | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-020-01417-6

  A systematic review of longitudinal studies suggests that the incidence of GERD has increased in recent decades. If this trend continues, it may rapidly increase the serious complications of GERD, affect the patients quality of life, and increase the cost of health care systems. […] Increasing the GERD awareness to improve Iranian peoples health may be necessary. There is much information in Western cultures that can be generalized to an Iranian person but cannot match completely. Therefore, understanding the epidemiological effects of GERD in Iranian society can help healthcare professionals and policymakers take the next steps in creating the list of priorities for disease management.

• #78 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  The aim of the current review was to search the literature systematically using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 guidelines and estimate the global prevalence of GORD, the prevalence of GORD according to geographical location and to identify risk factors associated with an increased risk of the condition. […] The pooled prevalence of GORD in females (17.17%) was moderately higher than in males (15.69%). […] The pooled prevalence of GORD according to age groups displayed an increase with increasing age between the age groups of 18-34 years (8.70%) and 35-59 years (14.53%). […] The pooled prevalence of GORD according to alcohol intake showed a similar GORD prevalence in those who do not drink alcohol or have a low intake of alcohol (15.95%) compared with those who have a moderate to high intake of alcohol (15.56%).

• #79 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  The aim of the current review was to search the literature systematically using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 guidelines and estimate the global prevalence of GORD, the prevalence of GORD according to geographical location and to identify risk factors associated with an increased risk of the condition. […] The pooled prevalence of GORD in females (17.17%) was moderately higher than in males (15.69%). […] The pooled prevalence of GORD according to age groups displayed an increase with increasing age between the age groups of 18-34 years (8.70%) and 35-59 years (14.53%). […] The pooled prevalence of GORD according to alcohol intake showed a similar GORD prevalence in those who do not drink alcohol or have a low intake of alcohol (15.95%) compared with those who have a moderate to high intake of alcohol (15.56%).

• #80 Reflux Esophagitis Pathology: Definition, Epidemiology, Etiology

  https://emedicine.medscape.com/article/1610393-overview

  A Swedish population-based, cross-sectional study compared the prevalence of gastroesophageal reflux symptoms among English and Swedish populations and reported a higher prevalence of reflux symptoms occurring at least twice weekly in English populations compared with Swedish populations. […] With regard to sex-related differences, some studies report no sex predilection. Other studies indicate that males are more likely to develop severe forms of esophagitis and complications such as Barrett esophagus and esophageal adenocarcinoma. Conversely, females are more frequently affected by nonerosive reflux disease (NERD) and symptomatic GERD. The prevalence of reflux esophagitis increases with age, particularly in females after their 50s. […] As noted in adults, there is an increasing trend of GERD in the pediatric population too. Nelson et al reported an increased incidence of GERD that ranged from 12% to 50% in children aged 0-18 years between 2000 and 2005.

• #81 Gastroesophageal Reflux Disease: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/176595-overview

  Western dietary habits have made GERD a common disease. The prevalence of GERD in Western populations is estimated to be 10-20%, whereas it is about 2.5-17.0% in Asian populations. […] Richter and associates reported that 25%-40% of Americans experience symptomatic GERD at some point. Approximately 7%-10% of Americans experience symptoms of GERD on a daily basis. Because many individuals control their symptoms with over-the-counter (OTC) medications and without consulting a medical professional, the actual number of individuals with GERD is probably higher. […] No sexual predilection exists: GERD is as common in men as in women. However, the male-to-female incidence ratio for esophagitis is 2:1-3:1. The male-to-female incidence ratio for Barrett esophagus is 10:1. White males are at a greater risk for Barrett esophagus and adenocarcinoma than other populations. […] GERD occurs in all age groups. The prevalence of GERD increases in people older than 40 years.

• #82 Reflux Esophagitis Pathology: Definition, Epidemiology, Etiology

  https://emedicine.medscape.com/article/1610393-overview

  Interestingly, a study out of Taiwan by Chen et al showed seasonal variation in the incidence of GERD. Investigators evaluated a total of 76,636 ambulatory care visits for the treatment of GERD between 2001 and 2006 and reported that the incidence of GERD increased in autumn and winter for each sex, age group, as well as combined groups. They also reported that relative humidity showed a negative association with monthly GERD incidence in men and in the age group of those older than 64 years.

• #83 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Stratified pooled prevalence of GORD by BMI showed an increase in GORD prevalence as BMI increased. […] The prevalence of GORD was highest in subjects with low education level (16.78%), followed by those with medium education level (11.52%), and the lowest GORD prevalence was seen in those with a high education level (8.98%). […] When the pooled prevalence of GORD was stratified according to marriage status, the highest prevalence of GORD was found in divorced/separated/widowed individuals (22.95%) followed by married individuals (15.98%), and the lowest GORD prevalence was seen in single individuals (12.85%). […] The pooled prevalence of GORD according to NSAIDs/aspirin use showed a significantly greater prevalence of GORD in subjects using NSAIDs/aspirin (24.47%) compared with those who do not (17.34%).

• #84 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Stratified pooled prevalence of GORD by BMI showed an increase in GORD prevalence as BMI increased. […] The prevalence of GORD was highest in subjects with low education level (16.78%), followed by those with medium education level (11.52%), and the lowest GORD prevalence was seen in those with a high education level (8.98%). […] When the pooled prevalence of GORD was stratified according to marriage status, the highest prevalence of GORD was found in divorced/separated/widowed individuals (22.95%) followed by married individuals (15.98%), and the lowest GORD prevalence was seen in single individuals (12.85%). […] The pooled prevalence of GORD according to NSAIDs/aspirin use showed a significantly greater prevalence of GORD in subjects using NSAIDs/aspirin (24.47%) compared with those who do not (17.34%).

• #85 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Stratified pooled prevalence of GORD by BMI showed an increase in GORD prevalence as BMI increased. […] The prevalence of GORD was highest in subjects with low education level (16.78%), followed by those with medium education level (11.52%), and the lowest GORD prevalence was seen in those with a high education level (8.98%). […] When the pooled prevalence of GORD was stratified according to marriage status, the highest prevalence of GORD was found in divorced/separated/widowed individuals (22.95%) followed by married individuals (15.98%), and the lowest GORD prevalence was seen in single individuals (12.85%). […] The pooled prevalence of GORD according to NSAIDs/aspirin use showed a significantly greater prevalence of GORD in subjects using NSAIDs/aspirin (24.47%) compared with those who do not (17.34%).

• #86 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Stratified pooled prevalence of GORD by BMI showed an increase in GORD prevalence as BMI increased. […] The prevalence of GORD was highest in subjects with low education level (16.78%), followed by those with medium education level (11.52%), and the lowest GORD prevalence was seen in those with a high education level (8.98%). […] When the pooled prevalence of GORD was stratified according to marriage status, the highest prevalence of GORD was found in divorced/separated/widowed individuals (22.95%) followed by married individuals (15.98%), and the lowest GORD prevalence was seen in single individuals (12.85%). […] The pooled prevalence of GORD according to NSAIDs/aspirin use showed a significantly greater prevalence of GORD in subjects using NSAIDs/aspirin (24.47%) compared with those who do not (17.34%).

• #87 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  The area of domicile also had a significant effect on the prevalence of GORD. The pooled prevalence of GORD in subjects living in an urban area was the highest (13.43%) followed by subjects living in a rural area (11.70%). […] The pooled prevalence of GORD according to smoking habits showed that subjects who currently smoke had a higher prevalence of GORD (18.40%) compared with ex-smokers (16.83%) and non-smokers (15.55%). […] Subjects with a low income had a significantly higher prevalence of GORD (11.69%) than those with a medium income (8.42%) and those with a high income (7.68%). […] The effect of dietary intake of certain food and drinks (spicy food, sweet food, meat/fish, carbonated drinks, fatty food, fried food, and coffee/tea) on the pooled prevalence of GORD was also investigated.

• #88 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  The area of domicile also had a significant effect on the prevalence of GORD. The pooled prevalence of GORD in subjects living in an urban area was the highest (13.43%) followed by subjects living in a rural area (11.70%). […] The pooled prevalence of GORD according to smoking habits showed that subjects who currently smoke had a higher prevalence of GORD (18.40%) compared with ex-smokers (16.83%) and non-smokers (15.55%). […] Subjects with a low income had a significantly higher prevalence of GORD (11.69%) than those with a medium income (8.42%) and those with a high income (7.68%). […] The effect of dietary intake of certain food and drinks (spicy food, sweet food, meat/fish, carbonated drinks, fatty food, fried food, and coffee/tea) on the pooled prevalence of GORD was also investigated.

• #89 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  The aim of the current review was to search the literature systematically using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 guidelines and estimate the global prevalence of GORD, the prevalence of GORD according to geographical location and to identify risk factors associated with an increased risk of the condition. […] The pooled prevalence of GORD in females (17.17%) was moderately higher than in males (15.69%). […] The pooled prevalence of GORD according to age groups displayed an increase with increasing age between the age groups of 18-34 years (8.70%) and 35-59 years (14.53%). […] The pooled prevalence of GORD according to alcohol intake showed a similar GORD prevalence in those who do not drink alcohol or have a low intake of alcohol (15.95%) compared with those who have a moderate to high intake of alcohol (15.56%).

• #90 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Subjects with a moderate/high intake of carbonated drinks had a higher pooled prevalence of GORD than those with low/none intake (18.60% vs 14.54%, respectively). […] Pooling prevalence of GORD according to intake of coffee/tea revealed a higher GORD prevalence in subjects with a moderate/high intake of coffee/tea (21.02%) than those with a low/none intake (16.92%). […] This comprehensive systematic review has demonstrated the significant global burden of GORD with approximately 1.03 billion individuals suffering from the condition globally. […] It has also confirmed substantial variations in the pooled prevalence of GORD between regions and countries.

• #91 Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-020-62795-1

  Subjects with a moderate/high intake of carbonated drinks had a higher pooled prevalence of GORD than those with low/none intake (18.60% vs 14.54%, respectively). […] Pooling prevalence of GORD according to intake of coffee/tea revealed a higher GORD prevalence in subjects with a moderate/high intake of coffee/tea (21.02%) than those with a low/none intake (16.92%). […] This comprehensive systematic review has demonstrated the significant global burden of GORD with approximately 1.03 billion individuals suffering from the condition globally. […] It has also confirmed substantial variations in the pooled prevalence of GORD between regions and countries.

• #92 Bile reflux – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bile-reflux/diagnosis-treatment/drc-20370121

  A description of your symptoms and knowledge of your medical history is usually enough for your doctor to diagnose a reflux problem. But distinguishing between acid reflux and bile reflux is difficult and requires further testing. […] There is little evidence assessing the effectiveness of bile reflux treatments, in part because of the difficulty of establishing bile reflux as the cause of symptoms. […] However, there’s little evidence about the surgery’s effectiveness for bile reflux. […] Make an appointment with your doctor if you have signs or symptoms common to bile reflux.

• #93 Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9484982/

  Although there is no golden standard for diagnosis of BRG, four vital techniques including hepatobiliary scintigraphy, gastroscopy with aspiration of gastric juice, fiberoptic bilirubin monitoring, and esophageal impedance-pH testing are commonly recognized. […] To date, there is still no official and unified therapeutic regimen for patients with BRG.

• #94 Bile reflux – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bile-reflux/diagnosis-treatment/drc-20370121

  A description of your symptoms and knowledge of your medical history is usually enough for your doctor to diagnose a reflux problem. But distinguishing between acid reflux and bile reflux is difficult and requires further testing. […] There is little evidence assessing the effectiveness of bile reflux treatments, in part because of the difficulty of establishing bile reflux as the cause of symptoms. […] However, there’s little evidence about the surgery’s effectiveness for bile reflux. […] Make an appointment with your doctor if you have signs or symptoms common to bile reflux.

• #95 Gastro-esophageal reflux disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/gastro-oesophageal-reflux-disease?lang=us

  It affects 10% to 20% of the adult population in the United States and Western countries. […] The difficulty in the radiographic diagnosis of gastro-esophageal reflux disease lies in the presence of spontaneous reflux on upper GI examination in 20% of normal individuals, while some patients with pathologic gastro-esophageal reflux disease may present with reflux only after provocative maneuvers such as Valsalva, leg raising, and coughing.

• #96 Bile reflux – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bile-reflux/diagnosis-treatment/drc-20370121

  A description of your symptoms and knowledge of your medical history is usually enough for your doctor to diagnose a reflux problem. But distinguishing between acid reflux and bile reflux is difficult and requires further testing. […] There is little evidence assessing the effectiveness of bile reflux treatments, in part because of the difficulty of establishing bile reflux as the cause of symptoms. […] However, there’s little evidence about the surgery’s effectiveness for bile reflux. […] Make an appointment with your doctor if you have signs or symptoms common to bile reflux.

• #97 Reflux – Acid or Bile? Know the difference | Gastrointestinal Associates

  https://gihealthcare.com/reflux-acid-or-bile-know-the-difference/

  Bile reflux may occur in conjunction with GERD or may be misdiagnosed as GERD because the symptoms of the two conditions are very similar. […] Like GERD, identifying and treating bile reflux is important. When left untreated it can result in serious, sometimes life-threatening problems, such as esophageal ulcers that bleed and Barretts esophagus, a condition in which the cells in the lining of the esophagus transform into tissue similar to the type that lines the stomach. […] Bile reflux is common in individuals who have had surgery to remove their gallbladder or those who have undergone gastric surgery, including a total or partial removal of the stomach (gastrectomy) or gastric bypass surgery for weight loss. It also is common in patients with peptic ulcers. […] Because the symptoms of acid reflux and bile reflux are so similar, it is impossible to make a diagnosis of bile reflux based on symptoms alone.

• #98 Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=09608923&AN=156152475&h=2GJSF1PJyF73OrmExRmYCU%2BoFWw%2BjcMGvN%2BzHbLqzHqmgzAxks37ppS5Hp6Rsr8U54CuaRl3y9HmsOarH0GluA%3D%3D&crl=c

  Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery. […] Purpose: Excellent metabolic improvement following one anastomosis gastric bypass (OAGB) remains compromised by the risk of esophageal bile reflux and theoretical carcinogenic potential. […] No 'gold standard’ investigation exists for esophageal bile reflux, with diverse methods employed in the few studies evaluating it post-obesity surgery. […] As such, data on the incidence and severity of esophageal bile reflux is limited, with comparative studies lacking. […] Results: Gastric reflux of bile was identified by biliary scintigraphy in 14 OAGB (70%), one RYGB (5%) and four SG participants (31%), with a mean of 2.9% (SD 1.5) reflux (% of total radioactivity). […] One participant (OAGB) demonstrated esophageal bile reflux. […] Conclusion: Despite high incidence of gastric bile reflux post-OAGB, esophageal bile reflux is rare. […] With scarce literature of tumour development post-OAGB, frequent low-volume gastric bile reflux likely bears little clinical consequence; however, longer-term studies are needed.

• #99 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  The growing epidemic of obesity and the increase in weight loss surgery has led to a resurgence of interest in biliary reflux because anatomical alterations may be refluxogenic. […] HIDA scan is the least invasive scan with good patient tolerability, sensitivity and reproducibility for the diagnosis of biliary reflux. […] Patients with more advanced oesophageal lesions have a higher degree of duodenal reflux. It has been shown in animal models and in vitro that there is more Barrett’s and dysplasia with duodenal reflux. […] Prospective trials on OAGB should include endoscopy preoperatively and at 5-year intervals, to have data on the real effects of bile exposure on the gastric reservoir and oesophagus. […] In the latest systematic review analysing the prevalence, symptoms, lesions and treatment of DGOR, several studies both in vitro and in vivo have implicated duodenal contents in the pathogenesis of oesophagogastric lesions.

• #100 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  Recent trials that have attempted to directly treat bile as a component of gastro-oesophageal reflux disease (GORD) have demonstrated an improvement in symptoms and lesions in these patients. […] A new therapy, called IW-3718 (Colesevelam), binds and neutralises bile in the stomach, decreasing the volume of reflux and improving endoscopic imaging in 87% of cases, while also increasing muscle tissue relaxation. […] Despite the known histopathological links between oesophageal mucosal exposure to bile and carcinogenesis, only two cases of gastric pouch/distal oesophageal malignancy have been described in 20 years since the advent of OAGB. […] These results suggest that prospective trials of OAGB should include endoscopy preoperatively and at 5-year intervals to provide data on the true effects of bile exposure in the gastric reservoir and oesophagus. […] The HIDA scan is a sensitive measure of remnant pathology and is a readily available non-invasive test.

• #101 Bile Reflux: Clinical Considerations – Gastroenterology Advisor

  https://www.gastroenterologyadvisor.com/features/tips-for-distinguishing-and-treating-biliary-reflux/

  Certain patients may develop biliary reflux based on having an acid-bile pocket in the proximal part of the stomach; this leads to a collection of bile and may predispose the patient to esophageal reflux. […] Identification of biliary reflux is important, as patients experiencing this can have more severe mucosal damage in the esophagus, including BE. […] A study conducted by Dixon et al found that patients with BE had more evidence of bile related gastritis compared with those reported as having only GERD or nonulcer dyspepsia. […] This study, along with others, raises the question as to whether there is a carcinogenic role of bile reflux. […] Therefore, patients with evidence of bile reflux should be considered for more aggressive therapy, in the hopes of potentially preventing negative sequelae such as BE. […] The authors concluded that duodeno-gastric bile reflux was present in at least 1/3 of patients with functional dyspepsia.

• #102 Bile Reflux: Clinical Considerations – Gastroenterology Advisor

  https://www.gastroenterologyadvisor.com/features/tips-for-distinguishing-and-treating-biliary-reflux/

  Certain patients may develop biliary reflux based on having an acid-bile pocket in the proximal part of the stomach; this leads to a collection of bile and may predispose the patient to esophageal reflux. […] Identification of biliary reflux is important, as patients experiencing this can have more severe mucosal damage in the esophagus, including BE. […] A study conducted by Dixon et al found that patients with BE had more evidence of bile related gastritis compared with those reported as having only GERD or nonulcer dyspepsia. […] This study, along with others, raises the question as to whether there is a carcinogenic role of bile reflux. […] Therefore, patients with evidence of bile reflux should be considered for more aggressive therapy, in the hopes of potentially preventing negative sequelae such as BE. […] The authors concluded that duodeno-gastric bile reflux was present in at least 1/3 of patients with functional dyspepsia.

• #103 Roles and action mechanisms of bile acid-induced gastric intestinal metaplasia: a review | Cell Death Discovery

  https://www.nature.com/articles/s41420-022-00962-1

  Long-term exposure to bile acids has been shown to increase the risk of transition from normal mucosa to IM, and eventually leads to the development of GC over many years. […] However, there are no clear studies on whether bile-reflux monitoring can be used to monitor and delay the development of gastric IM. […] Currently, there is a controversial debate whether or not gastric IM is reversible. […] It is generally believed that H. pylori eradication before the occurrence of gastric IM can help control gastritis, while once gastric IM is established, H. pylori eradication cannot reverse gastric IM but can help prevent or delay the progression of gastric IM. […] Therefore, more evidence is needed to determine whether H. pylori eradication can delay and reverse IM. […] In summary, the symptoms caused by bile reflux can be alleviated by drugs and surgery. However, there are no high-quality studies on whether the treatment of bile reflux can reverse IM.

• #104 Roles and action mechanisms of bile acid-induced gastric intestinal metaplasia: a review | Cell Death Discovery

  https://www.nature.com/articles/s41420-022-00962-1

  Long-term exposure to bile acids has been shown to increase the risk of transition from normal mucosa to IM, and eventually leads to the development of GC over many years. […] However, there are no clear studies on whether bile-reflux monitoring can be used to monitor and delay the development of gastric IM. […] Currently, there is a controversial debate whether or not gastric IM is reversible. […] It is generally believed that H. pylori eradication before the occurrence of gastric IM can help control gastritis, while once gastric IM is established, H. pylori eradication cannot reverse gastric IM but can help prevent or delay the progression of gastric IM. […] Therefore, more evidence is needed to determine whether H. pylori eradication can delay and reverse IM. […] In summary, the symptoms caused by bile reflux can be alleviated by drugs and surgery. However, there are no high-quality studies on whether the treatment of bile reflux can reverse IM.

• #105 Bile reflux after bariatric surgery | Cirugía Española (English Edition)

  https://www.elsevier.es/es-revista-cirugia-espanola-english-edition–436-articulo-bile-reflux-after-bariatric-surgery-S2173507723002235

  The growing epidemic of obesity and the increase in weight loss surgery has led to a resurgence of interest in biliary reflux because anatomical alterations may be refluxogenic. […] HIDA scan is the least invasive scan with good patient tolerability, sensitivity and reproducibility for the diagnosis of biliary reflux. […] Patients with more advanced oesophageal lesions have a higher degree of duodenal reflux. It has been shown in animal models and in vitro that there is more Barrett’s and dysplasia with duodenal reflux. […] Prospective trials on OAGB should include endoscopy preoperatively and at 5-year intervals, to have data on the real effects of bile exposure on the gastric reservoir and oesophagus. […] In the latest systematic review analysing the prevalence, symptoms, lesions and treatment of DGOR, several studies both in vitro and in vivo have implicated duodenal contents in the pathogenesis of oesophagogastric lesions.

• #106 Bile Reflux following Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) and its Surgical Treatment : Bariatric Times

  https://bariatrictimes.com/bile-reflux-sadis-surgical-treatment/

  Bile reflux following the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) procedure is rare. The reported incidence of bile reflux following the SADI-S procedure is 0.1 percent. […] Bile reflux can occur months to years after SADI-S. If it occurs, it can be fixed easily with surgical treatment.

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