AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED).The development of EAC was investigated in rats exposed to duodenogastric juice of different pH.The rats were divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 rats in each group).The incidence of esophagitis,Barrett’s esophagus (BE),intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment.RESULTS:The incidence rate of esophagitis,BE,intestinal metaplasia with dysplasia and EAC was higher in groups A and B compared with the control group after 40 wk (P < 0.01),being 96% and 100% (P > 0.05),88% and 82.4% (P > 0.05),20% and 52.1% (P < 0.05),and 8% and 39% (P < 0.05),respectively.CONCLUSION:Non-acidic refluxate increases the occurrence of intestinal metaplasia with dysplasia and EAC while the low-pH gastric juice exerts a protective effect in the presence of duodenal juice.The non-acid reflux is particularly important in the progression from BE to cancer.Therefore,control of duodenal reflux may be an important prophylaxis for EAC. AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED).The development of EAC was investigated In rats exposed to duodenogastric juice of different pH.The rats were divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 Rats in each group).The incidence of esophagitis,Barrett’s esophagus (BE),intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment.RESULTS:The incidence rate of esophagitis,BE,intestinal metaplasia with dysplasia and EAC was higher in Group A and B compared with the control group after 40 weeks (P < 0.01), being 96% and 100% (P> 0.05), 88% and 82.4% (P> 0.05), 20% and 52.1% (P < 0.05 ),and 8% and 39% (P < 0.05),respectively.CONCLUSION:Non-acidic refluxate increases the occurrence of The intestinal metaplasia with dysplasia and EAC while the low-pH gastric juice exerts a protective effect in the presence of duodenal juice. The non-acid reflux is particularly important in the progression from BE to cancer.Therefore,control of duodenal reflux may be an important Prophylaxis for EAC.