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Antony P. Barlow, MD; Tom R. DeMeester, MD; Chris S. Ball, MD; Ernst P. Eypasch, MD

Arch Surg. 1989;124(8):937-940.

Abstract
• The gastric secretory status of 75 patients with abnormal esophageal exposure to gastric juice proved by 24-hour pH monitoring was measured to study the significance of gastric hypersecretion in gastroesophageal reflux disease. Gastric hypersecretion was a less-frequent finding than a mechanically defective sphincter (28% vs 72%, respectively). Forty-eight percent of patients with a normal sphincter, compared with 20% of those with a defective sphincter, were hypersecretors. In the presence of normal gastric secretion, complications occurred in 18% of those with a normal sphincter and 77% of those with a defective sphincter. In the presence of hypersecretion, the complication rate was 40% and 82%, respectively. These findings show that the development of reflux complications are related to a defective sphincter. Gastric hypersecretion in reflux patients with a normal sphincter is best treated by acid reduction using H2 blockers. Patients with a mechanically defective sphincter, regardless of their gastric secretory state, should have an antireflux procedure.

(Arch Surg. 1989;124:937-940)

Author Affiliations
From the Department of Surgery, Creighton University School of Medicine, Omaha, Neb.

Footnotes
Accepted for publication February 27, 1989.

Read before the 96th Annual Meeting of the Western Surgical Association, San Diego, Calif, November 16, 1988.

Reprint requests to Department of Surgery, Creighton University School of Medicine, 601N 30th St, Omaha, NE 68131 (Dr DeMeester).

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