Radionuclide test for gastric bile reflux.

The authors conducted a study using radioactive endogenous bile to detect gastric bile reflux in healthy volunteers and patients suspected of having bile gastritis. When 7 muCi of pyridoxylideneglutamate of hydroxyiminodiacetic acid labelled with technetium-99m is injected intravenously it is excreted by hepatocytes, and sequential gamma camera images visualize the bile ducts and show subsequent activity in the gut. Following such an injection, the authors determined the presence of isotope-labelled bile in the stomach in fasting subjects by assaying count rates in serial gastric aspirates obtained by means of a nasogastric tube positioned in the antrum. The results were related to the clinical history and gastroscopic findings. In normal persons only extremely low counts were detected, possibly due to free activity; high counts (in excess of 50 000/min) indicated abnormal reflux. It is suggested that this test is a useful adjunct, and is more physiologic than endoscopy, in the assessment of bile reflux.