DOI: 10.33631/sabd.1925125 ISSN: 2792-0542

Endoscopic Bile Reflux and Associated Gastric Mucosal Findings: A Retrospective Observational Study

Erman Yekenkurul, Eray Kurnaz, Mehmet Fuat Çetin, Mehmet Emin Gönüllü, Fatih Gürsoy, Mevlüt Pehlivan
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Aim: This study aimed to evaluate the distribution of endoscopic bile reflux and accompanying gastric mucosal findings in a large patient cohort and to investigate their association with demographic and clinical variables.Material and Methods: This retrospective, single-center study included 446 adult patients who underwent upper gastrointestinal endoscopy between January 2020 and December 2025. Endoscopic findings, including erythema, mucosal edema, bile reflux, hyperemia, and erosive changes, were recorded. Demographic and clinical variables, including age, sex, smoking status, and alcohol use, were analyzed. Associations were evaluated using univariate analyses and multivariable logistic regression.Results: Erythema was the most frequently observed finding (70.0%), followed by mucosal edema (55.6%), hyperemia (49.6%), bile reflux (43.9%), and erosive changes (23.3%). Bile reflux and erosive changes were more frequently observed in older patients and in those with smoking. In multivariable analysis, age ≥50 years (OR: 1.62, 95% CI: 1.08–2.42, p=0.021) and smoking (OR: 1.58, 95% CI: 1.05–2.37, p=0.028) were associated with bile reflux. Multiple concurrent endoscopic findings were present in a substantial proportion of patients.Conclusion: Endoscopic bile reflux and associated gastric mucosal abnormalities are common and exhibit variable associations with demographic and clinical factors. Given the non-specific nature of many endoscopic findings, their clinical interpretation should be made cautiously. Further prospective studies incorporating histopathological evaluation are needed to clarify their diagnostic and clinical relevance.

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