To investigate clinicopathologic findings and gallbladder (GB) function in patients with endoscopic bile reflux at outpatients clinic.

We classified endoscopic bile reflux into two groups by bile reflux index (BRI). Those who scored above 14 were the BRI (+) group, and those below 14 were the BRI (-) group. We analyzed clinical characteristics, endoscopic findings including Helicobacter pylori, GB function by DISIDA scan, and electron microscope (EM) findings of endoscopic bile reflux. And we compared clinicopathologic characteristics and GB function between two groups.

Endoscopic bile reflux identified in 9.7% of all cases with gastrointestinal symptoms. There are cholecystectomy in 6.7%, gastrectomy in 2.7%, and GB dysfunction in 20.0%. They had prominent gastrointestinal symptoms with variable endoscopic findings. Foveolar hyperplasia is the most common pathologic finding and H. pylori colonization of the stomach was inhibited in cases of bile reflux gastritis. Bile reflux also had distinguishable ultra-structural changes identifiable by EM. BRI (+) group had more old age, GB dysfunction than BRI (-) group. Clinical symptoms and endoscopic findings did not differ between the two groups of endoscopic bile reflux.

Endoscopic bile reflux was common findings with young adults (30's) at outpatients clinic. Foveolar hyperplasia is common pathologic finding. GB dysfunction were identified as significant risk factors for BRI (+) group.

Sydney system in the classfication of histologic gastritis recommends the grading of Helicobacter(H.) pylori density, activity and chronic inflammation. CLO test is a rapid urease test to diagnose H. pylori infection. The relation between the grading of gastritis and the positivity of the CLO test has not been well studied. Accordingly, this study was performed to investigate the positive rate of the CLO test according to the grade of gastritis.

One hundred consecutive endoscopy patients had two antral biopsies for CLO test and histopathologic examination. H. pylori density, activity and inflammation were each graded into 0, 1, 2, and 3.

1) CLO test was positive in 52 among 100 cases(52%) and among the CLO test positive cases, forty five(86.5%) became positive within 1 hour.

2) The positive rate of the CLO test increased according to the grade of H. pylori density, mucosal activity and chronic inflammation.

3) The group(n=45) who turned positive within 1 hour showed higher grade of H. pylori density than the group(n=7) who turned positive from 1 to 24 hour.

It was thought that the grade of histologic gastritis reflected the positive rate of the CLO test and reaction time to a positive CLO test is related to H. pylori density.