Recurrent symptoms after fundoplication with a negative pH study--recurrent reflux or functional heartburn?

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Sarah K ThompsonPeter G Devitt

Abstract

A small cohort of patients present after antireflux surgery complaining of recurrent heartburn. Over two thirds of these patients will have a negative 24-h pH study. The aim of our study is to determine whether these patients have an associated functional disorder or abnormal cytokine activity and to examine the reproducibility of pH testing. A prospective analysis was carried out on a cohort of patients who had undergone a fundoplication and postoperative pH testing for recurrent heartburn: group A--patients with recurrent heartburn and a negative 24-h pH study and group B (control group)--patients with recurrent heartburn and a positive pH study. Questionnaires, a blood sample, and repeat pH testing were completed. Sixty-nine patients were identified. Group A's depression score (8.6 +/- 4.1) was significantly higher than group B's (5.9 +/- 4.2; P = 0.03). Cytokine levels were similar in both groups. Forty-seven of 49 (96%) patients who underwent repeat pH testing had a negative study. Symptom-reflux correlation was highly significant (P < 0.001). Some patients with recurrent heartburn and a negative pH study have associated functional or psychiatric comorbidities such as depression. Reproducibility of 24-h pH testing in these...Continue Reading

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Citations

Aug 24, 2011·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Toygar ToydemirMehmet Ali Yerdel
Nov 6, 2010·World Journal of Surgery·Dharmendran RatnasingamDavid I Watson
Mar 28, 2012·Current Gastroenterology Reports·Frank ZerbibJean Paul Galmiche
Aug 8, 2013·Scandinavian Journal of Gastroenterology·Anna RydénNimish Vakil

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