Duodenogastric reflux disease: Risk factors, the role of mrcp in the evaluation of anatomic pathology in etiology, h. pylori association, evaluation of clinical and histopathological response to combined ursodeoxycholic acid and sucralfate therapy

Duodenogastric Reflux Disease (DGRH) is defined as the epigastric pain / burning, dyspepsi, nausea, vomiting and weight loss due to the damage of gastric mucosa by reflux of bile salts, pancreatic enzymes and the alkaline content in the duodenum. Gastrointestinal motility disorders, biliary tract and pancreatic duct anomalies and pylorus insufficiency are implicated in etiopathogenesis. Thirty-two patients who presented with refractory reflux symptoms and diagnosed with endoscopy with duodenogastric reflux were included. The control group included 32 patients with similar symptoms who were not diagnosed duodenogastric reflux with endoscopy. The demographic characteristics of the patients (sex, parental consanguinity, family story), the presence of anatomic pathology in magnetic resonance cholangiopancreatography, histopathological and clinical responses of Ursodeoxycholic acid and Sucralfate were evaluated. To assess the effect of Duodenogastric reflux on Helicobacter pylori (H. pylori) frequency of H. pylori was compared with the control group. Clinical scoring was performed to determine the severity and prognosis of the disease. Of the 32 patients who participated in the study, 26 (81.3%) were female, 6 had parental consanguinity (18.8%), and 1 patient had family history. Magnetic resonance cholangiopancreatography (MRCP) was performed in 30 patients and there was anatomic pathology in 3 patients (10%). H. pylori infection was present in 13 (40.6%) of 32 patients in the duodenogastric reflux group and in 14 (43%) of 32 patients in the control group. All of the patients received UDKA and sucralfate treatment for at least 6 months and at the end of the sixth month, endoscopy was performed and histopathological and clinical evaluation were performed. The histopathological and clinical improvement in the patients after six months of treatment was statistically significant. As a result, female gender, family history, and parental consanguinity are risk factors for duodenogastric reflux. In patients with duodenogastric reflux, MRCP may be useful in the evaluation of anatomic pathologies in the bile ducts that may be involved in etiology. Clinical scoring will be useful as it will provide information about the severity and prognosis of the disease. Ursodeoxycholic Acid and Sucralfat treatment for six months is providing histopathological and clinical improvement in duodenogastric reflux disease.