The possible role of duodenogastric reflux in the pathogenesis of both gastric and duodenal ulcers.

Duodenogastric reflux was assessed scintigraphically in normal subjects (n = 20) and in patients with duodenal (n = 15) or gastric ulcers (n = 14). Reflux was graded 0-4 according to degree and was minimal in the control group (0.25 +/- 0.12) (mean +/- SEM), but significantly increased in 11 out of 15 patients with duodenal ulceration (1.33 +/- 0.25) and in 12 out of 14 patients with gastric ulceration (1.86 +/- 0.29) (P less than or equal to 0.0025). Gastric mucosal biopsies taken at endoscopy showed changes of gastritis which correlated well with the degree of reflux. It is suggested therefore that duodenogastric reflux may play a significant role in the pathogenesis of some peptic ulcers, and may be responsible for many of the pathophysiological changes seen in these patients.