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01-01-2009 | original article

Recurrent Symptoms after Fundoplication with a Negative pH Study—Recurrent Reflux or Functional Heartburn?

Authors: Sarah K. Thompson, Wang Cai, Glyn G. Jamieson, Alison Y. Zhang, Jennifer C. Myers, Zoe E. Parr, David I. Watson, Jenny Persson, Gerald Holtmann, Peter G. Devitt

Published in: Journal of Gastrointestinal Surgery | Issue 1/2009

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.

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Title: Recurrent Symptoms after Fundoplication with a Negative pH Study—Recurrent Reflux or Functional Heartburn?
Authors: Sarah K. Thompson
Wang Cai
Glyn G. Jamieson
Alison Y. Zhang
Jennifer C. Myers
Zoe E. Parr
David I. Watson
Jenny Persson
Gerald Holtmann
Peter G. Devitt
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 1/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0653-1

2024 ASCO Annual Meeting

Springer Medicine

Recurrent Symptoms after Fundoplication with a Negative pH Study—Recurrent Reflux or Functional Heartburn?

Abstract

Introduction

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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