A simple test for the detection of oesophageal reflux
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Although this series is rather small, yet the study made it possible to obtain some provisional information:
It is very difficult to diagnose reflux with any degree of accuracy by studying the biochemical composition of the oesophageal aspirates.
In this series, free hydrochloric acid could be detected in the gastric aspirates in only 25% of the tests and was therefore useless as an indicator for the detection of reflux without prior administration of histamine.
Pepsin activity could be detected in the gastric aspirates of only 50% of the cases. We did not attempt any injection of insulin or histamine in order to enhance production of pepsin for the purpose of using it as an indicator of reflux.
It was noted that the incidence of oesophagitis, as detected by oesophagoscopy, was more related to peptic activity than to the level of acidity.
A study of the pH, or the amylase activity was utterly useless as an aid for the detection of reflux.
A positive test for reflux in the presence of free hydrochloric acid and pepsin was found to be consistently associated with oesophagitis.
Oesophageal aspiration, after the introduction of a dye into the stomach, may have a place in the investigation of reflux.
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