1First Department of Internal Medicine Toho University School of Medicine, 2Ultrasonographic Laboratory Toho University School of Medicine
Atrophic change in the gastric mucosa, Color Doppler ultrasonography, Duodenogastric reflux, Pepsinogen
To evaluate the clinical significance of duodenogastric reflux (DGR) observed by color Doppler ultrasonography after oral
administration of consomme, we studied the correlation between DGR and atrophic changes in the gastric mucosa. Sixty-one
patients who had undergone dye-endoscopic examination by the 0.05% crystal violet spraying method were examined with color
Doppler ultrasonography using a model SSA 270 A (Toshiba) ultrasound unit. DGR was measured for 5 minutes after oral
administration of 400 ml of consomme to seated subjects who had fasted overnight. We also took blood at this time to determine
levels of serum pepsinogen 1 (PG 1) and 2 (PG 2). Atrophic change in the gastric mucosa was evaluated by the position of the
functional atrophic border (C-l, C-2, O-l, O-2, O-3) using dye-endoscopy with the 0.05% crystal violet spraying method.
A functional atrophic border was clearly demonstrated as a line between the blue and purple zones. In addition, grade of
atrophic change was represented quantitatively by serum concentrations of PG 1 and PG 2. Patients of type O-3 had DGR more
frequently than did those of types O-2 and C-2. The higher the grade of intestinal metaplasia, the greater the significant increase
in frequency of DGR. We conclude that DGR, a gastroduodenal motility disorder, would appear to be closely related to
atrophic change in the gastric mucosa and the distribution of intestinal metaplasia of the stomach.