Postprandial Proximal Gastric Acid Pocket in Patients after Roux-En-Y Gastric Bypass

Abstract

PPGAP is present in a minority of patients after RYGB; this finding may explain part of the GERD control after RYGB and that the gastric fundus may play a role in the genesis of the PPGAP.

Postprandial proximal gastric acid pocket in patients after distal gastrectomy

“…These findings suggest that the PPGAP is not only based on a physical principal of a hydrophilic acid floating over a lipophilic meal or gravity. Gastric anatomy and physiology must be contributory to the PPGAP genesis as it is a common finding in individuals with an intact stomach with or without GERD, given that different studies reported a prevalence of 100%, 1–3 but in only 20% of patients after postoperative alteration of the gastric fundus, such as after Roux‐en‐Y gastric bypass 4 or Nissen fundoplication 9 …”

“…An unbuffered postprandial proximal gastric acid pocket (PPGAP) has been noticed in the majority of normal individuals and patients with gastroesophageal reflux disease (GERD) 1–3 but in only 20% of patients after exclusion of the gastric fundus as in patients submitted to Roux‐en‐Y gastric bypass 4 . The role of gastric anatomy, specifically the antrum, in the physiology of the PPGAP is not yet fully elucidated.…”

Postprandial proximal gastric acid pocket in patients after laparoscopic Nissen fundoplication

“…The genesis of the PPGAP may be linked to gastric motility [9] and gastric anatomy [10]. We planned to study LNF patients in order to evaluate the contribution of the change in gastric anatomy to the prevalence of the PPGAP and the effect of an antireflux operation on the PPGAP.…”

Postprandial proximal gastric acid pocket and gastroesophageal reflux disease

“…Interestingly, the authors did not use manometric landmarks. Subsequent studies used the same methodology based on endoscopic‐placed clips and the manometric determined LES 7,10 or manometric landmarks only 4,6,11–14 . 99mTc‐pertechnetate scintigraphy has also been used to mark PPGAP position within the stomach 10 …”

“…Our group studied PPGAP in patients after gastric surgery 11–14 . Three types of gastric operation were studied in order to determine the influence of gastric anatomy on the PPGAP.…”