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Twenty-four-Hour pH Monitoring of Esophageal FunctionIts Use in Evaluation in Symptomatic Patients After Truncal Vagotomy and Gastric Resection or Drainage
Gerald C. O'Sullivan, MD, MSc, FRCS(I);
Tom R. DeMeester, MD;
Robin B. Smith, ChM, FRCS;
James W. Ryan, MD;
Lawrence F. Johnson, MD;
David B. Skinner, MD
Arch Surg. 1981;116(5):581-590.
Abstract
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• The incidence and character of gastrointestinal reflux after truncal vagotomy and gastric resection or drainage were studied prospectively in 42 symptomatic patients. Gastroesophageal reflux, proven by 24-hour pH monitoring, occurred in 31 patients. Initial symptoms of heartburn, regurgitation, or dysphagia were similar in patients with and without reflux. Eighteen patients had pure acid, nine had acid-alkaline, and four had pure alkaline reflux. Reflux occurred predominantly in the supine position. Esophagitis occurred only in patients with reflux and was not dependent on the pH of refluxed material. Reflux was eventually controlled by antireflux repair in 19 and by colon interposition in three patients. Twenty-four-hour esophageal pH monitoring is beneficial in evaluating symptoms after gastric surgery. It quantifies both acid and alkaline reflux, provides an objective assessment of the patient's subjective complaints, and gives a rational basis for management.
(Arch Surg 1981;116:581-590)
Author Affiliations
From the Departments of Surgery (Drs O'Sullivan, DeMeester, Smith, and Skinner), and Radiology (Dr Ryan), The University of Chicago Pritzker School of Medicine; and Department of Gastroenterology, Walter Reed Army Medical Center, Washington, DC (Dr Johnson).
Footnotes
Accepted for publication Jan 19, 1981.
Read before the 88th annual meeting of the Western Surgical Association, Salt Lake City, Nov 18, 1980.
Reprint requests to Department of Surgery, Box 440, The University of Chicago, 950 E 59th St, Chicago, IL 60637 (Dr DeMeester).
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