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Animal studies suggest that synergism between acid and pepsin and conjugated bile acids have the greatest damaging potential for oesophageal mucosa, although unconjugated bile acids may be caustic at more neutral pH.<\/jats:p><jats:p>Human studies are compatible with a synergistic action between acid and duodenogastric reflux in inducing lesions. During prolonged monitoring studies, typical gastro\u2010oesophageal reflux symptoms are more related to acid reflux events than to non\u2010acid reflux events.<\/jats:p><jats:p>However, symptoms that persist during acid suppressive therapy are often related to non\u2010acid reflux events. The therapeutic options for the non\u2010acid component of the refluxate, including acid suppression, prokinetics, baclofen, surgery and mucosal protective agents like alginates, are discussed.<\/jats:p>","DOI":"10.1111\/j.1365-2036.2006.03040.x","type":"journal-article","created":{"date-parts":[[2010,7,23]],"date-time":"2010-07-23T11:39:38Z","timestamp":1279885178000},"page":"10-16","source":"Crossref","is-referenced-by-count":48,"title":["Review article: the role of bile and pepsin in the pathophysiology and treatment of gastro\u2010oesophageal reflux 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