DUODENOGASTRIC REFLUX IN HEALTH AND DISEASE

十二指肠胃反流(DGR)是一种定义不明确的情况，它是 难以准确诊断。确实需要一种简单的 可用于定义存在和严重程度的测试 疾病。胃腔内pH值的长期监测是有希望的 在这方面。第一个目标是测量胃腔的pH值 正常人的贲门和幽门的不同平面 志愿者和狗来确定不同部位的PH值是如何变化的 在正常生理条件下的胃。PH环境为 可能受进食、姿势变化、DGR、胃排空的影响 和酸分泌，因此管腔内的pH环境将是 在胃的不同部位进行了长时间的地图绘制 不同的生理活动，包括进食，姿势变化，诱导 DGR和胃动力及胃酸分泌改变。在这样的背景下 信息，计算机辅助分析有症状的胃pH数据 患者将帮助确定病理性DGR的疾病是否真的 与现有测试的比较将表明是否延长了 胃内pH值测定本身可用于诊断 条件。 DGR的外科治疗包括Roux-en-Y手术的使用 这会导致胃肠功能的深刻变化。我们有 最近开发了一种替代手术(“十二指肠切断术”)， 似乎更具生理性，因为不需要迷走神经切断术，而且 幽门前机制完好无损。这两个手术程序将 在动物和人类身上进行分析和比较。的一项关键功能 “十二指肠开关”包括抑制十二指肠的胃酸分泌。 反馈机制。这将用巴甫洛夫袋在狗身上进行研究。 这个项目的结果将使我们更好地了解 DGR现象，对病理性DGR更明确的诊断，并将 探索一种新的手术疗法的生理优势。

Duodenogastric reflux (DGR) is a poorly defined condition which is difficult to accurately diagnose. There is a definite need for a simple test which can be used to define both the existence and severity of the disease. The long term monitoring of gastric intraluminal pH holds promise in this respect. The first aim is to measure the gastric luminal pH at different levels between the cardia and the pylorus in normal human volunteers and dogs to determine how the pH varies in different parts of the stomach under normal physiological conditions. The pH environment is probably influenced by eating, changes in posture, DGR, gastric emptying and acid secretion, therefore the intraluminal pH environment will be mapped at different sites in the stomach over prolonged periods of different physiologic activity including eating, posture change, induced DGR and altered gastric motility and acid secretion. With this background information, computer assisted analysis of gastric pH data in symptomatic patients will help define whether the disease of pathologic DGR indeed exists and a comparison with existing tests will indicate whether prolonged intragastric pH measurements on their own can be used in diagnosing the condition. Surgical therapy of DGR has included the use of the Roux-en-Y operation which results in profound alterations in gastrointestinal function. We have recently developed an alternative operation (the "duodenal switch") which appears to be more physiologic in that no vagotomy is required and the antro-pyloric mechanism is left intact. These two surgical procedures will be analyzed and compared in both animals and humans. A key feature of the "duodenal switch" involves suppression of acid secretion by a duodenal feedback mechanism. This will be studied using Pavlov pouches in dogs. The results of this project will provide a better understanding of the phenomenon of DGR, more definitive diagnosis of pathologic DGR, and will explore the physiological advantages of a new surgical therapy.