P1.024. Rabeprazole Is Effective for Bile Reflux Esophagitis After Total Gastrectomy in a Rat Model

Topic Benign Disease: Gastro-Esophageal Reflux and Hiatal Hernia Background To elucidate the effect of proton pump inhibitor (PPI,Rabeprazol;e) on reflux esophagitis. Methods Twenty -one 8 week old male Wistar rats were studied. They were performed esophagoduodenostomy of total gastrectomy to induce esophageal reflux of biliary and pancreatic juice. Five rats were performed the sham operation (Sham) (n=8). On the postoperative day 7, they were treated with saline (Control) (n=8) or PPI (Rabeprazole 30mg/kg per day, ip) (n=8) for 2 weeks. On the postoperative 21 days, all rats were sacrificed and each esophagus was evaluated histologically. Esophageal injury was evaluated by macroscopic and microscopic findings as well as the expression of COX2. We measured bile acid in the esophageal lumen and common bile duct. Results The macroscopic ulcer score and microscopic ulcer length of the control group were significantly higher compared to those of the Rabeprazole treated group. The expression of COX2 was significantly increased in the control group compared to Rabeprazole treated group. Although there was no difference between the control and PPI groups in the total bile acids in the common bile duct, the bile acid in the esophageal lumen was significantly decreased in the Rabeprazole treated group due to augmentation of the duodenal motor complex. Conclusion These results indicate that bile acid,inhibited by Rabeprazole, plays an important role in mucosal damage induced by duodenal reflux.