Korean J Gastroenterol.  2002 Apr;39(4):248-253.

Intragastric Bile Acid Concentration and Intestinal Metaplasia in the Gastric Mucosa

• Kim DH
• Park NW
• Joo KR
• Lee SH
• Kim SR
• Yoo CI
• Suh JH
• Park JH

Abstract

BACKGROUND/AIMS: Enterogastric reflux of bile has been suspected as a risk factor of foregut cancer. Thus, we measured total intragastric bile acid to determine association between duodenogastric reflux and development of intestinal metaplasia known as premalignant gastric mucosal change.
METHODS
One hundred and three patients with a functional dyspepsia underwent endoscopy. Subsequently, samples of fasting gastric juice were taken from all patients for analysis of total bile acid. With the specimens from 5 sites of the antrum and body, the degree of intestinal metaplasia was evaluated by the update Sydney System and H. pylori infection was evaluated also by Warthin-Starry staining.
RESULTS
There was a significant correlation between the total bile acid level and the degree of intestinal metaplasia (r=0.278, p=0.005). Moreover, multiple linear regression test showed that the concentration of total bile acid was one of the independent risk factors for intestinal metaplasia regardless of age and H. pylori infection.
CONCLUSIONS
These results suggest that intragastric bile acid may affect histologic premalignant changes of the gastric mucosa and thus, duodenogastric reflux may play a role in gastric carcinogenesis.

Keyword

Duodenogastric reflux; Intestinal metaplasia; Gastric cancer; Bile acid

MeSH Terms

Bile*
Carcinogenesis
Duodenogastric Reflux
Dyspepsia
Endoscopy
Fasting
Gastric Juice
Gastric Mucosa*
Humans
Linear Models
Metaplasia*
Risk Factors
Stomach Neoplasms