Intragastric total bile acid concentrations were measured before and after a corn oil test meal in 16 patients with erosive oesophagitis and symptoms of gastro-oesophageal reflux. Sixteen age and sex matched control subjects were also studied. No significant difference was detected between fasting or postprandial gastric bile acid concentrations in patients and in control subjects although a wide range of bile acid concentrations was detected among individuals in both groups. Gastric juice pH was less than 3.5 in seven patients when intragastric bile acid concentrations were greater than 200 mumol/l. These results do not support a role for abnormal duodenogastric reflux in the pathogenesis of erosive oesophagitis. The detection of acid reflux in such patients during intra-oesophageal pH monitoring, however, does not exclude the presence of bile acids which may contribute to the cytotoxic potential of gastric juice.
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