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Type: Journal article
Title: Recurrent heartburn after Laparoscopic Fundoplication is not always recurrent reflux
Author: Thompson, S.
Jamieson, G.
Myers, J.
Chin, K.
Watson, D.
Devitt, P.
Citation: Journal of Gastrointestinal Surgery, 2007; 11(5):642-647
Publisher: Elsevier Svience Inc
Issue Date: 2007
ISSN: 1091-255X
Statement of
Sarah K. Thompson, Glyn G. Jamieson, Jennifer C. Myers, Kin-Fah Chin, David I. Watson and Peter G. Devitt
Abstract: Introduction: A small cohort of patients present after antireflux surgery complaining of recurrent heartburn. Many of these patients have been empirically recommenced on proton pump inhibitors. Objective: The aim of this study was to determine whether patients with symptoms that suggest recurrent reflux had objective evidence of reflux, and to determine predictors of recurrent reflux. Methods: We identified all patients from an existing database who had undergone pH monitoring for “recurrent heartburn” after fundoplication. These patients were then cross-referenced to another database, which recorded the outcomes for patients who had undergone a laparoscopic fundoplication. Patients complaining of dysphagia or other problems without heartburn were excluded from analysis. Results: Seventy-six patients were identified who met the inclusion criteria. Fifty-six (74%) of these had a normal 24-h pH study. Thirty-five patients (63%) with a normal pH study were on medication for heartburn at the time of referral. Three factors were found to be associated with an abnormal 24-h pH study: a partial fundoplication (P = 0.039), onset of symptoms 6 months or more after surgery (P < 0.001), and a good symptom response when antireflux medication was recommenced (P = 0.015). Conclusions Not all patients complaining of recurrent heartburn after fundoplication have evidence of abnormal reflux. Objective evidence of abnormal esophageal acid exposure should be confirmed before recommencing antireflux medication.
Keywords: Laparoscopic fundoplication
Recurrent heartburn
Recurrent reflux
24-h pH study
Description: Presented at the 10th World Congress of the International Society for Diseases of the Esophagus (ISDE), Adelaide Convention Center, South Australia, Australia, February 24, 2006
DOI: 10.1007/s11605-007-0163-6
Appears in Collections:Aurora harvest
Surgery publications

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