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Symptomatic and physiologic outcomes after operative treatment for extraesophageal reflux.
Surg Endosc. 2002 Jul; 16(7):1032-6.SE

Abstract

BACKGROUND

Pharyngeal pH monitoring has recently been used to identify patients with extraesophageal symptoms induced by gastroesophageal reflux. We employed this method of acid detection to evaluate patients with respiratory symptoms prior to and after laparoscopic Nissen fundoplication to further elucidate the relationship between GERD and respiratory symptoms.

METHODS

Twenty-one consecutive patients with extraesophageal symptoms thought to be caused by reflux underwent symptomatic and functional evaluation (esophageal manometry and 24-h pH monitoring with a pharyngeal probe) before and after laparoscopic Nissen fundoplication. Episodes of pharyngeal acid exposure were considered abnormal if the pH dropped below 4, occurred simultaneously with esophageal acidification, and occurred outside meal times.

RESULTS

All patients had gastroesophageal reflux disease (GERD) and respiratory symptoms; nine of 15 (60%) had evidence of pharyngeal reflux preoperatively. Antireflux procedures resulted in a significant decrease in pharyngeal reflux (7.9 to 1.6 episodes/24h; p <0.05) and esophageal acid exposure (7.5% to 2.1%; p <0.05). In patients with pharyngeal reflux and complete postoperative testing, three (60%) obtained improvement of respiratory symptoms and resolution of pharyngeal reflux. In two patients with recurrent respiratory symptoms after surgery, persistent pharyngeal reflux was detected.

CONCLUSION

Operative treatment of GERD is effective in controlling extraesophageal reflux, measured subjectively and objectively. Evidence of pharyngeal reflux on pH testing helps to identify which patients with respiratory symptoms will benefit from an antireflux procedure.

Authors+Show Affiliations

Department of Surgery, Swallowing Center, University of Washington, 1959 N.E. Pacific Street, Seattle, WA 98195-6410, USA. brant@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11984664

Citation

Oelschlager, B K., et al. "Symptomatic and Physiologic Outcomes After Operative Treatment for Extraesophageal Reflux." Surgical Endoscopy, vol. 16, no. 7, 2002, pp. 1032-6.
Oelschlager BK, Eubanks TR, Oleynikov D, et al. Symptomatic and physiologic outcomes after operative treatment for extraesophageal reflux. Surg Endosc. 2002;16(7):1032-6.
Oelschlager, B. K., Eubanks, T. R., Oleynikov, D., Pope, C., & Pellegrini, C. A. (2002). Symptomatic and physiologic outcomes after operative treatment for extraesophageal reflux. Surgical Endoscopy, 16(7), 1032-6.
Oelschlager BK, et al. Symptomatic and Physiologic Outcomes After Operative Treatment for Extraesophageal Reflux. Surg Endosc. 2002;16(7):1032-6. PubMed PMID: 11984664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptomatic and physiologic outcomes after operative treatment for extraesophageal reflux. AU - Oelschlager,B K, AU - Eubanks,T R, AU - Oleynikov,D, AU - Pope,C, AU - Pellegrini,C A, Y1 - 2002/05/03/ PY - 2001/08/14/received PY - 2002/01/24/accepted PY - 2002/5/2/pubmed PY - 2002/9/17/medline PY - 2002/5/2/entrez SP - 1032 EP - 6 JF - Surgical endoscopy JO - Surg Endosc VL - 16 IS - 7 N2 - BACKGROUND: Pharyngeal pH monitoring has recently been used to identify patients with extraesophageal symptoms induced by gastroesophageal reflux. We employed this method of acid detection to evaluate patients with respiratory symptoms prior to and after laparoscopic Nissen fundoplication to further elucidate the relationship between GERD and respiratory symptoms. METHODS: Twenty-one consecutive patients with extraesophageal symptoms thought to be caused by reflux underwent symptomatic and functional evaluation (esophageal manometry and 24-h pH monitoring with a pharyngeal probe) before and after laparoscopic Nissen fundoplication. Episodes of pharyngeal acid exposure were considered abnormal if the pH dropped below 4, occurred simultaneously with esophageal acidification, and occurred outside meal times. RESULTS: All patients had gastroesophageal reflux disease (GERD) and respiratory symptoms; nine of 15 (60%) had evidence of pharyngeal reflux preoperatively. Antireflux procedures resulted in a significant decrease in pharyngeal reflux (7.9 to 1.6 episodes/24h; p <0.05) and esophageal acid exposure (7.5% to 2.1%; p <0.05). In patients with pharyngeal reflux and complete postoperative testing, three (60%) obtained improvement of respiratory symptoms and resolution of pharyngeal reflux. In two patients with recurrent respiratory symptoms after surgery, persistent pharyngeal reflux was detected. CONCLUSION: Operative treatment of GERD is effective in controlling extraesophageal reflux, measured subjectively and objectively. Evidence of pharyngeal reflux on pH testing helps to identify which patients with respiratory symptoms will benefit from an antireflux procedure. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/11984664/Symptomatic_and_physiologic_outcomes_after_operative_treatment_for_extraesophageal_reflux_ L2 - https://doi.org/10.1007/s00464-001-8252-1 DB - PRIME DP - Unbound Medicine ER -