Bile reflux gastritis in two adolescant patients, who became asymptomatic with ursodeoxycholic acid and sucralfate combination therapy in twelve weeks.

Öz

Bile reflux gastritis or alkaline reflux gastritis is due to an excessive reflux of bile, pancreatic and intestinal secretions into the stomach. Increased enterogastric reflux may cause gastric mucosal injury. These patients have dyspeptic symptoms that generally do not respond to acid suppressing medications. Here, we present two adolescent patients who underwent upper gastrointestinal endoscopy due to dyspeptic symptoms resistant to proton pump inhibitors (PPI) and who were diagnosed as alkaline reflux gastritis and became asymptomatic with ursodeoxycholic acid and sucralfate combination in twelve weeks.

 

Key words: Adolescents, bile reflux gastritis, ursodeoxycholic acid, sucralfate

Anahtar Kelimeler

• Adolescents, bile reflux gastritis, ursodeoxycholic acid, sucralfate

On İki Haftalık Ursodeoksikolik Asit ve Sükralfat Kombine Tedavisi ile Semptomları Kaybolan Safra Reflüsü Gastritli İki Adolesan Olgu

Öz

Safra reflüsü gastriti veya alkalen reflü gastriti; safra, pankreatik ve intestinal sekresyonların mideye aşırı kaçışına bağlı olarak oluşur. Artmış enterogastrik reflü mide mukozasında hasara yol açabilir. Bu hastalarda asit baskılayıcı tedavilere genellikle yanıt vermeyen dispeptik yakınmalar görülür. Burada proton pompa inhibitörüne (PPI) cevap vermeyen dispeptik yakınmaları nedeni ile üst gastrointestinal sistem endoskopisi yapılan ve alkalen reflü gastriti tanısı alan, on iki haftalık ursodeoksikolik asit ve sükralfat kombine tedavisi ile semptomları kaybolan iki adolesan olgu sunulmuştur.

 

Anahtar Kelimeler

• Safra reflüsü gastriti, ursodeoksikolik asit, sükralfat, adolesan

Kaynakça

1. Burden WR, Hodges RP, Hsu M, O’Leary JP. Alkaline reflux gastritis. Surg Clin North Am 1991;71:33–44.
2. Bonavina L, Incarbone R, Segalin A, Chella B, Peracchia A. Duodeno-gastro-oesophageal reflux after gastric surgery: surgical therapy and outcome in 42 consecutive patients. Hepato Gastroenterology 1999; 46:92–96.
3. Mason RJ, De Meester TR. Importance of duodenogastric reflux in the surgical outpatient practice. Hepato-Gastroenterology 1999;46:48–53.
4. Perdikis G, Wilson P, Hinder RA, Redmond E, Wetscher G,Neary P, Adrian T, Quigley E. Altered androduodenal motility after cholecystectomy. Am J Surg 1994;168:609–615.
5. Hermans D, Sokal EM, Collard JM, Romagnoli R, Buts JP. Primary duodenogastric reflux in children and adolescents. Eur J Pediatr 2003;162:598-602.
6. Dixon MF, bilier reflux gastritis and Barrett’s oesophagus further evidence of a role for duodenogastrooesophageal reflux Gut 2001; 49:359-63
7. Pazzi P, Scalia S, Stabellini G. Bile reflux gastritisin patients without prior gastric urgery: Therapeutic effects of ursodeoxycholic acid. Cur Ther Res 1989;45:476-80.
8. Vere CC, Cazacu S, Comanescu V, Mogoanta L, Rogoveanu I, Ciurea T. Endoscopic and histological features in bile reflux gastritis. Romanian Journal of Morphology and Embryology 2005,46(4):269–274.

9. Scarpa PJ, Cappell MS. Treatment with ursodeoxycholic acid of bile reflux gastritis after cholecystectomy. J Clin Gastroenterol 1991;13:601-3.
10. Stefaniwisky AB, Tint GS. Ursodoxycholic acid treatment of bile reflux gastritis. Gastroenterology 1985;89:1000-4.
11. Pazzi P, Stabellini G. Effect of UDCA on biliary dyspepsia in patient s without gallstones. Cur Their Res 1985;37:685-90.
12. Ozkaya M, Erten A, Sahin I, Engin B, Ciftci A, et al. The effect of ursodeoxycholic acid treatment on epidermal growth factor in patients with bile reflux gastritis. Turk J Gastroenterol 2002;13(4):198-202.
13. Santrelli L, Gabrielli M, Candelli M, Cremonini F, Nista EC, Cammarota G, et al. Post-cholecystectomy alkaline reactive gastritis: a randomized trial comparing sucralfate versus rabeprazole or no treatment. Eur J Gastroenterol Hepatol 2003;15(9):975-979.
14. Stefaniwsky AB, Tint GS, Speck J, Shefer S, Salen G. Ursodeoxycholic acid treatment of bile reflux gastritis. Gastroenterology. 1985;89(5):1000-1004.
15. Marshall RE, Anggiansah A, Manifold DK, Owen WA, Owen WJ. Effect of omeprazole 20 mg twice daily on duodenogastric and gastrooesophageal bile reflux in Barret’s oesophagus. Gut 1998;43(5):603-606.