Alkaline reflux esophagitis in gastroresected patients. Objective detection with a simple isotope method.

The incidence and severity of alkaline reflux esophagitis occurring in 1129 gastroresected patients were evaluated. As far as the incidence of esophagitis are concerned, no significant difference was found after Billroth I or Billroth II type resection. Severe esophagitis developed in 62.6 per cent of patients with total gastrectomy, but never occurred when a long limb Roux-en-Y anastomosis was also performed. The majority of esophagitis was recognized within the first year after resection, so it might be supposed that not only operative procedure itself but the postoperative care period might be responsible for the development of esophagitis. It can be avoided and treated by Roux-en-Y anastomosis. Scintigraphy is a simple rapid method in the detection of gastroesophageal reflux, thus patients can be selected by it for further invasive investigation.