Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/50635
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Type: Journal article
Title: Recurrent Symptoms after Fundoplication with a Negative pH Study--Recurrent Reflux or Functional Heartburn?
Author: Thompson, S.
Cai, W.
Jamieson, G.
Zhang, A.
Myers, J.
Parr, Z.
Watson, D.
Persson, J.
Holtmann, G.
Devitt, P.
Citation: Journal of Gastrointestinal Surgery, 2009; 13(1):54-60
Publisher: Elsevier Svience Inc
Issue Date: 2009
ISSN: 1091-255X
1873-4626
Statement of
Responsibility: 
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
RMID: 0020083882
DOI: 10.1007/s11605-008-0653-1
Appears in Collections:Surgery publications

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