PMID- 9171768
OWN - NLM
STAT- MEDLINE
DCOM- 19970710
LR  - 20061115
IS  - 0007-1323 (Print)
IS  - 0007-1323 (Linking)
VI  - 84
IP  - 5
DP  - 1997 May
TI  - Effect of fundoplication on transient lower oesophageal sphincter relaxation and 
      gas reflux.
PG  - 686-9
AB  - BACKGROUND: Fundoplication is used widely to treat severe gastro-oesophageal 
      reflux disease. Difficulty in belching and increased flatulence are common 
      side-effects. Transient lower oesophageal sphincter (LOS) relaxation is important 
      to help vent gas from the stomach. The effect of fundoplication on LOS function 
      and gas reflux was therefore investigated. METHODS: Oesophageal manometry was 
      performed before operation and 3-15 months after fundoplication in 14 patients 
      with reflux disease who had a total (360 degrees) fundoplication. Five patients 
      also had highly selective vagotomy. Gastric distension was induced by 750 ml 
      carbon dioxide. RESULTS: Fundoplication reduced the median number of episodes of 
      gas reflux during 10 min of gastric distension from 5 (interquartile range 
      (i.q.r.) 3-7) to 0 (i.q.r. 0), and the median number of transient LOS relaxations 
      from 4 (i.q.r. 2-6) to 0 (i.q.r. 0-1). Fundoplication did not affect basal LOS 
      pressure but significantly increased nadir pressure during swallow-induced 
      relaxation. CONCLUSION: Fundoplication controls reflux by inhibiting the 
      triggering of transient LOS relaxation and by preventing the complete ablation of 
      pressure at the gastro-oesophageal junction during LOS relaxation. These effects 
      may also contribute to the side-effects of the operation.
FAU - Johnsson, F
AU  - Johnsson F
AD  - Department of Gastrointestinal Medicine, Royal Adelaide Hospital, South 
      Australia.
FAU - Holloway, R H
AU  - Holloway RH
FAU - Ireland, A C
AU  - Ireland AC
FAU - Jamieson, G G
AU  - Jamieson GG
FAU - Dent, J
AU  - Dent J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
RN  - 0 (Gases)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Eructation/physiopathology
MH  - Esophagus/physiopathology
MH  - Female
MH  - *Fundoplication
MH  - Gases
MH  - Gastroesophageal Reflux/physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - Muscle Relaxation
MH  - Postoperative Care
MH  - Preoperative Care
MH  - Pressure
EDAT- 1997/05/01 00:00
MHDA- 1997/05/01 00:01
CRDT- 1997/05/01 00:00
PHST- 1997/05/01 00:00 [pubmed]
PHST- 1997/05/01 00:01 [medline]
PHST- 1997/05/01 00:00 [entrez]
PST - ppublish
SO  - Br J Surg. 1997 May;84(5):686-9.