| Recurrent heartburn after laparoscopic fundoplication is not always recurrent reflux. | |
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MedLine Citation:
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PMID: 17468924 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Sarah K Thompson; Glyn G Jamieson; Jennifer C Myers; Kin-Fah Chin; David I Watson; Peter G Devitt |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 11 ISSN: 1091-255X ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-30 Completed Date: 2007-09-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 642-7 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Adelaide, Level 5, Eleanor Harrald Building, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia. sarah.thompson@adelaide.edu.au |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Antacids / therapeutic use Cohort Studies Deglutition Disorders / diagnosis Esophageal pH Monitoring Esophagitis / diagnosis Esophagoscopy Female Follow-Up Studies Forecasting Fundoplication / adverse effects, methods* Gastroesophageal Reflux / diagnosis, surgery* H(+)-K(+)-Exchanging ATPase / antagonists & inhibitors Heartburn / diagnosis, etiology* Histamine H2 Antagonists / therapeutic use Humans Laparoscopy* Male Middle Aged Prospective Studies Recurrence Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antacids; 0/Histamine H2 Antagonists; EC 3.6.1.10/H(+)-K(+)-Exchanging ATPase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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