Characterization of reflux events after fundoplication using combined impedance–pH recording

Abstract

Fundoplication restores a competent barrier for all types of reflux. Reflux events are mostly non-acid after surgery, and such events may be positively correlated with symptoms.

Definitions of Gastroesophageal Reflux Disease (GERD)

“…While numbers of reflux events do decrease significantly with anti-reflux surgery in these instances [62], the thresholds alone may not necessarily segregate those with good response to therapy [63]. This may be partly related to the fact that duration of individual reflux events may vary dramatically, and patients with low numbers of reflux events could have significant acid or reflux exposure in the esophagus if prolonged.…”

Review article: intra‐oesophageal impedance monitoring for the assessment of bolus transit and gastro‐oesophageal reflux

“…In a recent study, characterization of reflux events after fundoplication was performed in 36 GERD patients using combined impedance pH-recording. 63 After surgery, almost all reflux events were non-acid and in some patients non-acid reflux events were significantly associated with symptoms. The mechanisms of acid, weakly acidic and gas reflux after antireflux surgery have been recently studied by concomitant use of impedance-pH monitoring and high resolution manometry in the postprandial period.…”

Prospective Study Examining the Impact of Multichannel Intraluminal Impedance on Antireflux Surgery

“…The design of the catheter allowed recording impedance data 3,5,7,9,15, and 17 cm above the lower esophageal sphincter (LES) and pH data 5 cm above the LES with a frequency of 50 Hz.…”

“…There are few reports on the role of MII-pH monitoring for patients who have undergone antireflux surgery [5]. Still, there is limited information on the role of MII-pH monitoring in the pre-and postoperative setting.…”