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.
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.
Authors: Amelia N Pilichiewicz; Michael Horowitz; Antonietta Russo; Anne F Maddox; Karen L Jones; Michael Schemann; Gerald Holtmann; Christine Feinle-Bisset Journal: Am J Gastroenterol Date: 2007-03-22 Impact factor: 10.864
Authors: Yashodhan S Khajanchee; Robert W O'Rourke; Barbara Lockhart; Emma J Patterson; Paul D Hansen; Lee L Swanstrom Journal: Arch Surg Date: 2002-09
Authors: Nimish Vakil; Karin Björck; Hans Denison; Katarina Halling; Maria Karlsson; Jean Paty; Debra G Silberg; Anna Rydén Journal: Clin Transl Gastroenterol Date: 2012-01-26 Impact factor: 4.488