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Acid Reflux Surgery Unaffected by Delayed Gastric Emptying

Last Updated: September 21, 2009.

Delayed gastric emptying does not affect control and relief of acid reflux in patients with gastroesophageal reflux disease who undergo Nissen fundoplication, although patients with delayed gastric emptying still have more dyspeptic symptoms, according to a study in the September issue of the Archives of Surgery.

MONDAY, Sept. 21 (HealthDay News) -- Delayed gastric emptying (DGE) does not affect control and relief of acid reflux in patients with gastroesophageal reflux disease who undergo Nissen fundoplication, although patients with DGE still have more dyspeptic symptoms, according to a study in the September issue of the Archives of Surgery.

Yashodhan S. Khajanchee, M.D., and colleagues from Legacy Health System in Portland, Ore., retrospectively analyzed outcomes from 141 patients with gastroesophageal reflux disease and symptoms of DGE considered for Nissen fundoplication. Of these, 63 had had DGE (time to 50 percent emptying >90 minutes) and underwent Nissen fundoplication and pyloroplasty, while the remaining 78 with normal gastric emptying (NGE) underwent Nissen fundoplication only.

At a mean follow up of 21 months, the researchers found that the DGE group and the NGE group had similar relief of reflux symptoms (85.7 versus 91.0 percent) and objective control of acid reflux (84.6 versus 80.3 percent). The DGE group had significant relief of dyspeptic symptoms, although the incidence remained significantly higher than the NGE group. Gastric emptying normalized in 88.23 percent of the 17 patients with data available. A comparison with 418 patients with no DGE symptoms who underwent Nissen fundoplication showed that postoperative objective outcomes were similar in all groups.

"DGE does not affect outcomes of gastroesophageal reflux disease following Nissen fundoplication, but patients with DGE have more postoperative gas and bloat and/or nausea compared with patients with NGE; this is mostly corrected by addition of a pyloroplasty," Khajanchee and colleagues conclude.

One author of the study reported serving as a consultant for Intuitive Surgical Inc., Coridien and Sanofi-Aventis, and being on the advisory boards of Apollo Endosurgery and Max Endoscopy.

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