The effect of fundoplication on the lower esophageal sphincter.

Fundoplication restores normal length and amplitude of pressure to the hypotensive lower esophageal sphincter. If the procedure is properly performed, symptomatic reflux is almost uniformly prevented. The operation is less successful in patients with esophageal stricture and in those without normal esophageal peristalsis. The effect of fundoplication on the lower sphincter is by mechanical restoration of sphincter strength and the normal physiologic neural response of the sphincter to increases in intragastric pressure.