AJP - Gastrointestinal and Liver Physiology, Vol 243, Issue 1 42-G47, Copyright © 1982 by American Physiological Society
Effect of liquid meals on duodenogastric reflux in humans
A. Sonnenberg, S. A. Muller-Lissner, H. F. Weiser, W. Muller-Duysing, F. Heinzel and A. L. Blum
In humans duodenogastric reflux and gastric emptying were measured
simultaneously by a two-marker technique that avoids transpyloric
intubation. The duodenal marker consisted of 99mTc-labeled Hepatobida and
was infused intravenously at a constant rate. Hepatobida was cleared almost
exclusively by the liver and entered the duodenum at a constant rate via
the bile. The gastric marker consisted of 51CrCl2 and was used to measure
total intragastric volume by the double-sampling technique. Duodenogastric
reflux occurred both after meals and under fasting conditions. Reflux rate
was on the average 13 times smaller than emptying rate. It was higher with
a lipid than with a protein meal and was independent of the rate of gastric
emptying. The gastric concentration and total amount of duodenal contents
were higher after lipid than protein meals. Since gastric emptying of a
protein meal was faster than emptying of a lipid meal, the increased
gastric concentration and accumulation of duodenal contents after lipid
meals are due to a slowed gastric clearing and increased reflux of duodenal
contents. Under fasting conditions, the reflux was lower and the gastric
concentration of duodenal contents was higher than with both types of
meals. Hence regurgitated duodenal contents may cause more damage to the
gastric mucosa under fasting conditions than postprandially.
