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|Title:||Recurrent Symptoms after Fundoplication with a Negative pH Study--Recurrent Reflux or Functional Heartburn?|
|Citation:||Journal of Gastrointestinal Surgery, 2009; 13(1):54-60|
|Publisher:||Elsevier Svience Inc|
|Sarah K. Thompson, Wang Cai, Glyn G. Jamieson, Alison Y. Zhang, Jennifer C. Myers, Zoe E. Parr, David I. Watson, Jenny Persson, Gerald Holtmann and Peter G. Devitt|
|Abstract:||Introduction 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. Methods 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. Results 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). Conclusion 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 patients is excellent.|
|Keywords:||Humans; Gastroesophageal Reflux; Recurrence; Heartburn; Laparoscopy; Prognosis; Fundoplication; Postoperative Period; Risk Factors; Follow-Up Studies; Prospective Studies; Hydrogen-Ion Concentration; Middle Aged; Female; Male; Esophageal pH Monitoring|
|Description:||© 2008 The Society for Surgery of the Alimentary Tract|
|Appears in Collections:||Surgery publications|
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