Materiały źródłowe

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

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

  Bile reflux occurs when the valves that keep bile from backwashing into your stomach and esophagus arent working properly. […] Chronic bile reflux can erode these protective linings, causing painful inflammation and, eventually, tissue damage (esophagitis). […] Chronic inflammation of your stomach lining (gastritis) can lead to stomach ulcers and is associated with a higher risk of stomach cancer. […] These risks are also associated with chronic gastroesophageal acid reflux (GERD), but studies show that bile reflux multiplies the risk. […] Treating bile reflux can be challenging, but healthcare providers have a few things up their sleeve that you can try. If medications dont work, and your symptoms are severe, surgery may be a solution. […] Prolonged exposure to bile can damage the linings of your stomach and esophagus. This can result in chronic inflammation, pain, and side effects such as ulcers.

• #2 Analysis of Risk Factors and Establishment of a Prediction Model for Endoscopic Primary Bile Reflux: A Single-Center Retrospective Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8631358/

  Being a male, age 45 years old, H. pylori infection, histories of MS, NSAIDs use, cholelithiasis, and erosive gastritis appear to be the risk factors for EPBR, and our favorable prediction model might be an option for the prediction of EPBR. […] Based on the results of these risk factors, an EPBR prediction model with an adequate calibration and excellent discrimination was established [area under the curve (AUC): 0.839, 95% CI = 0.8060.872]. […] The ROC analysis revealed that this model had an eminent discrimination ability due to the results of AUC 0.839 (95% CI, 0.8060.872) in the training set and 0.800 (95% CI, 0.7420.857) in the validation set, respectively.

• #3 Analysis of Risk Factors and Establishment of a Prediction Model for Endoscopic Primary Bile Reflux: A Single-Center Retrospective Study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34859013/

  Endoscopic primary bile reflux is one of the main diagnostic criteria for bile reflux gastritis (BRG). […] Thus, this study aimed to evaluate the risk factors of EPBR and to establish and verify a prediction model. […] Based on the results of these risk factors, an EPBR prediction model with an adequate calibration and excellent discrimination was established [area under the curve (AUC): 0.839, 95% CI = 0.806-0.872]. […] Being a male, age 45 years old, H. pylori infection, histories of MS, NSAIDs use, cholelithiasis, and erosive gastritis appear to be the risk factors for EPBR, and our favorable prediction model might be an option for the prediction of EPBR.

• #4 Bile Reflux Gastropathy and Functional Dyspepsia

  https://www.jnmjournal.org/view.html?uid=1687&vmd=Full

  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 was a significant predisposing risk factor for the development of bile reflux, and was associated with more severe gastrointestinal symptoms, and use of narcotic pain medications. […] The presence of bile gastritis during an upper endoscopy together with chemical gastropathy identified by histology is essential for a diagnosis. Given the rising incidence of cholecystectomy for unexplained abdominal pain, especially in the absence of pathologic gallbladder disease, we recommend caution and awareness of the association of BG and functional dyspepsia.

• #5 Bile Reflux Gastropathy and Functional Dyspepsia

  https://www.jnmjournal.org/journal/view.html?spage=400&volume=27&number=3

  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 was significantly associated with BG. […] Patients with cholecystectomy also reported significantly more severe abdominal pain, fullness, and nausea than patients without prior cholecystectomy. […] Cholecystectomy appears to be a significant risk factor for the development of BG.

• #6

  https://journals.lww.com/ctg/fulltext/2021/01000/meta_analysis_reveals_the_prognostic_relevance_of.14.aspx

  Bile acids (BAs) arising from duodenogastric reflux are known to facilitate gastric cancer (GC) development. […] High expression of all membrane but not nuclear BARs was associated with poor prognosis and unfavorable GC clinicopathologic features. […] Through transcriptomic meta-analysis, we identified distinct expression profiles between nuclear and membrane BARs that demonstrate prognostic relevance and warrant further investigation. […] Despite apparent downregulation in tumor tissue, high expression of BARs, and membrane BARs, in particular, is mainly associated with poor prognosis and unfavorable clinicopathologic features of GC. […] Overall, these results suggest that the expression of membrane but not those of nuclear BARs are differentially distributed among histologic subtype.

• #7

  https://journals.lww.com/ctg/fulltext/2021/01000/meta_analysis_reveals_the_prognostic_relevance_of.14.aspx

  Importantly, these results might provide a potential explanation underlying the difference between expression and prognosis because diffuse-type cancers are known to be more aggressive and associated with prognostically unfavorable tumor characteristics. […] Ultimately, this analysis supports the growing consensus that BARs are prognostically relevant biomarkers and important mediators of GC tumorigenesis.

• #8 Prebiotic proanthocyanidins inhibit bile reflux-induced esophageal adenocarcinoma through reshaping the gut microbiome and esophageal metabolome | bioRxiv

  https://www.biorxiv.org/content/10.1101/2023.08.22.554315v1.full-text

  The gut and local esophageal microbiome progressively shift from healthy commensal bacteria to inflammatory-linked pathogenic bacteria in patients with gastroesophageal reflux disease, Barrett’s esophagus and esophageal adenocarcinoma (EAC). […] Prognosis following a diagnosis of EAC remains poor as evidenced by <20% 5-year survival, supporting the urgent need for improved preventive strategies. [...] C-PAC is a safe promising dietary constituent that may be utilized alone or potentially as an adjuvant to current therapies to prevent EAC progression through ameliorating reflux-induced dysbiosis, inflammation and cellular damage.

• #9

  https://link.springer.com/article/10.1007/s11695-024-07362-7

  Gastro-esophageal reflux (GORD) following sleeve gastrectomy (SG) is a central challenge, and precise indications for revisional surgery or the physiology have not been precisely defined. […] We found OAGB is an effective treatment for reflux associated with delayed gastric emptying post-SG. […] This suggests that some forms of post-SG reflux are driven by slower emptying of the residual stomach and are amenable to treatment with drainage above the incisura. […] We have conducted a prospective clinical trial and found that OAGB and incisural uncoupling as an isolated procedure for severe reflux post-SG associated with delayed gastric emptying results in (1) acceleration in gastric emptying, (2) a substantial reduction in overall acid exposure and reflux events, and (3) improvement in symptoms of reflux in SG patients with troublesome reflux. […] This data suggests that OAGB is an effective treatment for gastro-stasis-induced reflux post-SG. We have shown reduced volume reflux events are likely due to the modified OAGB technique with drainage above the incisura leading to increased rapid gastric pouch clearance.

• #10 Symptoms, the GerdQ score and patients’ characteristics do not predict gastroesophageal reflux disease in patients with proton-pump-inhibitor-refractory reflux symptoms—results from a large prospective database [PeerJ]

  https://peerj.com/articles/14802/

  Based on our study, neither symptoms and the GerdQ score nor patients characteristics are appropriate tools to distinguish between GERD and other causes for reflux symptoms in patients with PPI-refractory reflux symptoms. […] Our study showed for the first time that the GerdQ is not an appropriate tool to distinguish between GERD and other causes in patients with PPI-refractory reflux symptoms. […] We could clearly demonstrate that neither symptoms per se and the established GerdQ score nor patients characteristics are of any reasonable predictive value with respect to the confirmation or exclusion of GERD.

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