Mechanisms underlying duodeno-gastric reflux in man

Neurogastroenterol Motil. 2005 Apr;17(2):191-9. doi: 10.1111/j.1365-2982.2004.00633.x.


Background: Recent studies suggest that duodeno-gastro-oesophageal reflux (DGER) contributes to the occurrence of reflux oesophagitis and Barrett's oesophagus. The mechanisms underlying duodeno-gastric reflux (DGR), a prerequisite for DGER, are poorly understood.

Aims: To study the occurrence of DGR in relation to interdigestive and postprandial gastroduodenal motility.

Subjects and methods: Ten healthy subjects underwent stationary gastroduodenal manometry with simultaneous duodenal and antral Bilitec recording 4 h before and 5 h after ingestion of a liquid meal. Eight volunteers underwent the same study, with administration of erythromycin postprandially.

Results: During the interdigestive phase II, all volunteers had short DGR episodes. Postprandially, DGR occurred in all subjects, on average 39 +/- 28 min after the start of the meal, and was cleared from the stomach after 242 +/- 23 min. Induction of increased antral motility and of a premature phase III, by administration of erythromycin, was associated with faster gastric DGR clearance. However, there was no direct temporal relationship between erythromycin-induced gastric phase III and erythromycin-induced DGR clearance.

Conclusion: In healthy subjects, duodenogastric reflux occurs sporadically in the interdigestive state and is a normal phenomenon in the postprandial period. Erythromycin induces faster clearance of DGR from the stomach, which depends on enhanced antral contractile activity rather than premature phase III.

MeSH terms

  • Adult
  • Duodenogastric Reflux / physiopathology*
  • Erythromycin / pharmacology
  • Female
  • Gastrointestinal Agents / pharmacology
  • Gastrointestinal Motility / drug effects
  • Gastrointestinal Motility / physiology*
  • Humans
  • Male
  • Manometry
  • Postprandial Period / physiology


  • Gastrointestinal Agents
  • Erythromycin