Reflux gastritis syndrome. Role of upper gastrointestinal microflora
H. Meshkinpour, L. D. Thrupp, P. Shiffler, D. Kitts and J. Fisher
Bacteriologic samplings of the upper gastrointestinal tract bile acids
profile of the intestinal contents were performed in eight patients with
reflux gastritis syndrome and three asymptomatic patients who had had
gastric surgery. All symptomatic patients showed colonization of the
gastric and/or intestinal samples with strains of enteric Gram-negative
bacteria and Pseudomonas. However, no single specific group or species was
consistently associated with reflux gastritis syndrome. The concentration
of total and conjugated bile acids was significantly greater in symptomatic
patients. Presence of free bile acids was correlated with heavier bacterial
colonization. To evaluate the effect of antibiotic therapy on bacterial
flora and symptoms, patients were studied for three separate four-week
evaluation periods. Following the first evaluation period, they were
assigned to receive either doxycycline or placebo in a crossover fashion
during the second and third periods. Total symptom scores did not differ
significantly and no specific patterns were evident in the bacterial flora.
These observations support the hypothesis that microbial flora is an
associated factor in reflux gastritis syndrome and may play an important
role only in certain individual patients.
