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Rudolph Pointner - One of the best experts on this subject based on the ideXlab platform.
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gas related symptoms after laparoscopic 360 nissen or 270 toupet fundoplication in gastrooesophageal reflux disease patients with Aerophagia as comorbidity
Digestive and Liver Disease, 2007Co-Authors: Frank A. Granderath, T. Kamolz, U. M. Granderath, Rudolph PointnerAbstract:Abstract Background Aerophagia is a rare but well-known comorbidity in patients with gastrooesophageal reflux disease. Particularly after laparoscopic Nissen fundoplication, it has proven to result in worse symptomatic outcome and a lower postoperative quality of life in comparison to patients without preoperative gas-related symptoms. Aims Aim of the study was to compare the postoperative outcome in gastrooesophageal reflux disease patients with Aerophagia as comorbidity after either laparoscopic 360° ‘floppy’ Nissen fundoplication or 270° Toupet fundoplication with main focus on the frequency and subjective impairment of gas-related symptoms. Patients and methods In 56 gastrooesophageal reflux disease patients, the comorbidity of Aerophagia was diagnosed prior to laparoscopic antireflux surgery. Irrespective of their preoperative manometric findings, the patients were either scheduled to a laparoscopic 360° ‘floppy’ Nissen (n = 28) or a laparoscopic 270° Toupet fundoplication (n = 28). All patients have been analysed concerning the presence of gas-related symptoms preoperatively as well as 3 months after surgery. Additionally, the subjective degree of impairment was evaluated using a numerous rating scale (0 = no perception/impairment, 100 = most severe perception/impairment). The following symptoms have been analysed: ability/inability to belch, ‘gas bloat’, flatulence, postprandial fullness and epigastric pain. Results Before surgery, there were no significant differences between both surgical groups. Three months after surgery, significant differences (p Conclusion Gas-related symptoms are very common in gastrooesophageal reflux disease patients with Aerophagia as a comorbidity. Patients who undergo a laparoscopic Toupet fundoplication show less impairment in relation to gas-related problems compared with patients treated with a Nissen fundoplication for a follow-up period of at least 3 months. In the Toupet group, the ability to belch postoperatively seems to be a positive aspect from the patients’ view which also improves the percentage of gas-related problems. However, long-term results are necessary.
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Gas-related symptoms after laparoscopic 360° Nissen or 270° Toupet fundoplication in gastrooesophageal reflux disease patients with Aerophagia as comorbidity
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2007Co-Authors: Frank A. Granderath, T. Kamolz, U. M. Granderath, Rudolph PointnerAbstract:Abstract Background Aerophagia is a rare but well-known comorbidity in patients with gastrooesophageal reflux disease. Particularly after laparoscopic Nissen fundoplication, it has proven to result in worse symptomatic outcome and a lower postoperative quality of life in comparison to patients without preoperative gas-related symptoms. Aims Aim of the study was to compare the postoperative outcome in gastrooesophageal reflux disease patients with Aerophagia as comorbidity after either laparoscopic 360° ‘floppy’ Nissen fundoplication or 270° Toupet fundoplication with main focus on the frequency and subjective impairment of gas-related symptoms. Patients and methods In 56 gastrooesophageal reflux disease patients, the comorbidity of Aerophagia was diagnosed prior to laparoscopic antireflux surgery. Irrespective of their preoperative manometric findings, the patients were either scheduled to a laparoscopic 360° ‘floppy’ Nissen (n = 28) or a laparoscopic 270° Toupet fundoplication (n = 28). All patients have been analysed concerning the presence of gas-related symptoms preoperatively as well as 3 months after surgery. Additionally, the subjective degree of impairment was evaluated using a numerous rating scale (0 = no perception/impairment, 100 = most severe perception/impairment). The following symptoms have been analysed: ability/inability to belch, ‘gas bloat’, flatulence, postprandial fullness and epigastric pain. Results Before surgery, there were no significant differences between both surgical groups. Three months after surgery, significant differences (p Conclusion Gas-related symptoms are very common in gastrooesophageal reflux disease patients with Aerophagia as a comorbidity. Patients who undergo a laparoscopic Toupet fundoplication show less impairment in relation to gas-related problems compared with patients treated with a Nissen fundoplication for a follow-up period of at least 3 months. In the Toupet group, the ability to belch postoperatively seems to be a positive aspect from the patients’ view which also improves the percentage of gas-related problems. However, long-term results are necessary.
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Comorbidity of Aerophagia in GERD patients: outcome of laparoscopic antireflux surgery.
Scandinavian journal of gastroenterology, 2002Co-Authors: T. Kamolz, T. Bammer, Frank A. Granderath, Rudolph PointnerAbstract:Background : While there is evidence that physiological data correlate poorly with quality-of-life data or patient-perceived symptom severity, most outcome studies of antireflux surgery still refer physiologic criteria. The aim of this prospective study was to establish whether concomitant Aerophagia in GERD (gastroesophageal reflux disease) patients might influence the surgical outcome of laparoscopic 'floppy' Nissen fundoplication. Methods : A total of 112 patients were divided into 2 subgroups: group 1 comprising GERD patients without Aerophagia ( n = 94; 84%); group 2 of GERD patients with concomitant Aerophagia ( n = 28; 16%). In all patients, requirements for surgery included an evaluation of symptoms (list of 17 symptoms; patients' grading from no - mild to moderate - severe), quality of life (Gastrointestinal Quality of Life Index: GIQLI), esophagogastroduodenoscopy, esophageal manometry and 24-h pH monitoring. Additionally, we asked for any potential stress relations to GERD symptoms. Surgical ou...
Albert J Bredenoord - One of the best experts on this subject based on the ideXlab platform.
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PERSPECTIVES IN CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Management of Belching, Hiccups, and Aerophagia
2013Co-Authors: Albert J BredenoordAbstract:Although belching and hiccups are regarded as normal behaviors, they can occur at high frequency or become persistent, becoming bothersome and requiring medical care. Patients with excessive belching frequently have supragastric belches. Excessive belching should be treated as a behavioral disorder. Persistent hiccups, however, can be the first presentation of a serious disorder that requires extensive diagnostic testing. When no cause is found, only the symptoms can be treated. Aerophagia is an episodic or chronic disorder in which patients (children and adults) swallow large quantities of air, which accumulate in the gastrointestinal tract to cause abdominal distention and bloating. These patients should not undergo explorative laparotomy because they do not have ileus. New treatment approaches are needed for patients with Aerophagia.
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Management of Belching, Hiccups, and Aerophagia
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2012Co-Authors: Albert J BredenoordAbstract:Although belching and hiccups are regarded as normal behaviors, they can occur at high frequency or become persistent, becoming bothersome and requiring medical care. Patients with excessive belching frequently have supragastric belches. Excessive belching should be treated as a behavioral disorder. Persistent hiccups, however, can be the first presentation of a serious disorder that requires extensive diagnostic testing. When no cause is found, only the symptoms can be treated. Aerophagia is an episodic or chronic disorder in which patients (children and adults) swallow large quantities of air, which accumulate in the gastrointestinal tract to cause abdominal distention and bloating. These patients should not undergo explorative laparotomy because they do not have ileus. New treatment approaches are needed for patients with Aerophagia.
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Sa1365 Aerophagia During Meals and Postprandial Gas-Containing Reflux in Patients With GERD Not Responding to PPI
Gastroenterology, 2012Co-Authors: I. Bravi, Albert J Bredenoord, Philip Woodland, Ravinder S. Gill, Jafar Jafari, Daniel SifrimAbstract:Introduction A significant number of GORD patients (30%) continue to perceive symptoms despite PPI therapy. Impedance-pH studies have shown that proximal extent of reflux and presence of gas in the refluxate are the only parameters associated with symptoms perception in refractory GORD. Increased air swallowing (Aerophagia) is often suspected based on clinical evaluation. More recently, increased air swallowing between meals was demonstrated, using oesophageal impedance, in a group of patients with increased abdominal gas (x-ray). Aerophagia during meals, however, may be more relevant for GORD patients with postprandial symptoms. We hypothesised that mealtime air swallowing may impact on post-prandial reflux patterns and symptoms in patients with refractory GORD. We aimed to assess Aerophagia during meals and postprandial gas reflux in GORD patients, responding or refractory to PPI. Methods Mealtime air swallows were quantified using ambulatory impedance-pH monitoring. Normal values were established from 39 healthy controls (mean age 39, range 22–62; Shay et al 2004). We studied 44 consecutive patients (mean age 48, range 19–78) with typical reflux symptoms and pathological oesophageal 24 h acid exposure. 18 were fully responsive and 26 were partially or unresponsive to PPI. Mealtime air swallows were defined as swallows with fast impedance increase (>3000Ω from baseline) in the distal recording segment. Mealtime air swallow frequency (air swallows/10 min meal) was calculated. Results There was no difference in mealtime air swallow frequency (mean±SEM 8.6±1.0 vs 8.0±0.7 per 10 min) or total mealtime air swallows (67.1±8.3 vs 54.0±5.3) between GORD patients and controls. In the GORD group, PPI-refractory patients had a higher frequency (10.5±1.4 vs 5.9±0.8, p Conclusion GORD patients had similar mealtime air swallowing to controls, but both groups had large inter-individual variability. Within GORD patients, PPI non-responders had more mealtime air swallowing than responders. Consequently non-responders had more reflux episodes containing gas, an important factor in reflux perception in GORD patients, who have hypersensitivity to oesophageal distension. Mealtime air swallowing may be amenable to behavioural therapy as an “add on” treatment in patients with incomplete response to PPI and objective Aerophagia during meals. Competing interests None declared.
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Objective Assessment of Aerophagia During Meals in Normal Subjects and Patients With Post-Prandial Bloating and Belching
Gastroenterology, 2011Co-Authors: Philip Woodland, Albert J Bredenoord, Ravinder S. Gill, Jafar Jafari, I. Bravi, Ryuichi Shimono, Asma Fikree, Jamal O. Hayat, Tatenda Marunda, Etsuro YazakiAbstract:Introduction Many patients attending GI physiology units for assessment of dysphagia and GORD also complain of postprandial bloating and/or belching. Excessive fasting Aerophagia has been recently described in patients with severe continuous bloating and belching. Exaggerated air swallowing during meals might be more relevant for postprandial symptoms but, thus far, objective assessment of prandial Aerophagia and normal values are lacking. Oesophageal impedance can detect air swallowing. We aimed to quantify Aerophagia during meals in asymptomatic subjects and patients with postprandial bloating and belching. Methods We assessed Aerophagia during meals using ambulatory impedance-pH monitoring in 39 healthy, asymptomatic controls (from the US-Belgian MII-pH Normal value study, Shay et al . 2004; mean age in original study 39, range 22–62) to establish normal 95% confidence intervals. We identified 38 patients (mean age 43, range 17–74) with postprandial bloating and/or belching who attended the GI physiology unit for assessment of dysphagia or GORD as primary symptoms. Mealtime air swallows were visually identified when swallows were associated with antegrade flow and fast impedance increase (at least 3000 Ω from baseline) in the most distal recording segment. A score of air swallows/10 min mealtime was calculated for each subject. In patients with mealtime exaggerated air swallowing (above 95th percentile of normal values) we examined for evidence of concomitant fasting Aerophagia. Results The 95% percentile range of mealtime Aerophagia in normal subjects was 6.8 to 9.4 episodes/10 min, mean 8.1. Patients had significantly higher mealtime air swallowing rates than controls (mean 11.8 episodes/10 min, SEM 1.0, p = 0.003 ). There was no significant difference between predominant bloating and belching subgroups. Only 4 of 23 patients with exaggerated mealtime air swallowing had concomitant fasting Aerophagia. Conclusion We established normal values of mealtime air swallowing using oesophageal impedance. Patients with postprandial bloating and/or belching exhibit increased Aerophagia during meals. Most of these patients do not have fasting Aerophagia. Exaggerated air swallowing during meals can now be objectively detected and biofeedback techniques can be attempted to modify such behaviour as a potential therapeutic strategy for these patients with functional GI symptoms.
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Aerophagia: Excessive Air Swallowing Demonstrated by Esophageal Impedance Monitoring
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2009Co-Authors: Gerrit J. Hemmink, Albert J Bredenoord, Bas L. Weusten, Robin Timmer, André J. P. M. SmoutAbstract:Background & Aims Patients with Aerophagia suffer from the presence of an excessive volume of intestinal gas, which is thought to result from excessive air ingestion. However, this has not been shown thus far. The aim of this study was therefore to assess swallowing and air swallowing frequencies in patients with suspected Aerophagia. Methods Ambulatory 24-hour pH-impedance monitoring was performed in patients in whom excessive amounts of intestinal gas were visualized on plain abdominal radiograms. All patients had symptoms of bloating, abdominal distention, flatulence, or excessive belching. Reflux parameters and the number of swallows and air swallows were assessed. Results The most common symptoms were bloating, abdominal distention, and constipation. Only 3 patients reported excessive belching and 1 patient reported flatulence as their predominant symptom. During the 24-hour measurement, patients showed high incidences of air swallows (521 ± 63) and gastric belches (126 ± 37). Patients had normal swallowing frequency (741 ± 71). Conclusions This study presents objective parameters that confirm the existence of excessive air swallowing or Aerophagia using esophageal impedance monitoring.
Shigeto Yamawaki - One of the best experts on this subject based on the ideXlab platform.
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Aerophagia a neuroleptic associated tardive syndrome
Human Psychopharmacology-clinical and Experimental, 1995Co-Authors: Teruo Hayashi, Tadashi Nishikawa, Kazuo Kado, Itsuyuki Koga, Yasunori Uchida, Shigeto YamawakiAbstract:Some cases suggestive of a tardive dyskinesia (TD)-induced esophageal movement disorder have been reported. We represent a patient with severe orofacial dyskinesia, an oesophageal movement disorder, and Aerophagia following long-term neuroleptic treatment. This 40-year-old mentally retarded man showed signs of oral dyskinesia over 20 years ago, with extension to his limbs and trunk within the last 5 years. He also demonstrated noisy air gulping every several seconds. An abdominal radiograph revealed a big magenblase and dilatated, air-filled segments of large and small intestine without a niveaus. Oesophageal contrastradiography revealed evidence of an oral dyskinesia involving the esophageal musculature and a dilated oesophagus (maximal width: 4·5 cm). Although the oesophageal dilatation was similar to that in patients with a spindle type of achalasia, the oesophageal-cardio junction was sometimes open completely, differing from conditions associated with achalasia. A polygraphic study revealed frequent high-amplitude bursts of microvibration, concurrent with the gulping. The signs of Aerophagia and laryngeal dyskinesia decreased 6 days following clonazepam administration. Thus, we suggested that tardive dyskinesia is associated with the laryngeal and oesophageal-induced Aerophagia. This is the first report of Aerophagia associated with neuroleptic-induced tardive syndrome.
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Aerophagia: A neuroleptic‐associated tardive syndrome?
Human Psychopharmacology: Clinical and Experimental, 1995Co-Authors: Teruo Hayashi, Tadashi Nishikawa, Kazuo Kado, Itsuyuki Koga, Yasunori Uchida, Shigeto YamawakiAbstract:Some cases suggestive of a tardive dyskinesia (TD)-induced esophageal movement disorder have been reported. We represent a patient with severe orofacial dyskinesia, an oesophageal movement disorder, and Aerophagia following long-term neuroleptic treatment. This 40-year-old mentally retarded man showed signs of oral dyskinesia over 20 years ago, with extension to his limbs and trunk within the last 5 years. He also demonstrated noisy air gulping every several seconds. An abdominal radiograph revealed a big magenblase and dilatated, air-filled segments of large and small intestine without a niveaus. Oesophageal contrastradiography revealed evidence of an oral dyskinesia involving the esophageal musculature and a dilated oesophagus (maximal width: 4·5 cm). Although the oesophageal dilatation was similar to that in patients with a spindle type of achalasia, the oesophageal-cardio junction was sometimes open completely, differing from conditions associated with achalasia. A polygraphic study revealed frequent high-amplitude bursts of microvibration, concurrent with the gulping. The signs of Aerophagia and laryngeal dyskinesia decreased 6 days following clonazepam administration. Thus, we suggested that tardive dyskinesia is associated with the laryngeal and oesophageal-induced Aerophagia. This is the first report of Aerophagia associated with neuroleptic-induced tardive syndrome.
Frank A. Granderath - One of the best experts on this subject based on the ideXlab platform.
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gas related symptoms after laparoscopic 360 nissen or 270 toupet fundoplication in gastrooesophageal reflux disease patients with Aerophagia as comorbidity
Digestive and Liver Disease, 2007Co-Authors: Frank A. Granderath, T. Kamolz, U. M. Granderath, Rudolph PointnerAbstract:Abstract Background Aerophagia is a rare but well-known comorbidity in patients with gastrooesophageal reflux disease. Particularly after laparoscopic Nissen fundoplication, it has proven to result in worse symptomatic outcome and a lower postoperative quality of life in comparison to patients without preoperative gas-related symptoms. Aims Aim of the study was to compare the postoperative outcome in gastrooesophageal reflux disease patients with Aerophagia as comorbidity after either laparoscopic 360° ‘floppy’ Nissen fundoplication or 270° Toupet fundoplication with main focus on the frequency and subjective impairment of gas-related symptoms. Patients and methods In 56 gastrooesophageal reflux disease patients, the comorbidity of Aerophagia was diagnosed prior to laparoscopic antireflux surgery. Irrespective of their preoperative manometric findings, the patients were either scheduled to a laparoscopic 360° ‘floppy’ Nissen (n = 28) or a laparoscopic 270° Toupet fundoplication (n = 28). All patients have been analysed concerning the presence of gas-related symptoms preoperatively as well as 3 months after surgery. Additionally, the subjective degree of impairment was evaluated using a numerous rating scale (0 = no perception/impairment, 100 = most severe perception/impairment). The following symptoms have been analysed: ability/inability to belch, ‘gas bloat’, flatulence, postprandial fullness and epigastric pain. Results Before surgery, there were no significant differences between both surgical groups. Three months after surgery, significant differences (p Conclusion Gas-related symptoms are very common in gastrooesophageal reflux disease patients with Aerophagia as a comorbidity. Patients who undergo a laparoscopic Toupet fundoplication show less impairment in relation to gas-related problems compared with patients treated with a Nissen fundoplication for a follow-up period of at least 3 months. In the Toupet group, the ability to belch postoperatively seems to be a positive aspect from the patients’ view which also improves the percentage of gas-related problems. However, long-term results are necessary.
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Gas-related symptoms after laparoscopic 360° Nissen or 270° Toupet fundoplication in gastrooesophageal reflux disease patients with Aerophagia as comorbidity
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2007Co-Authors: Frank A. Granderath, T. Kamolz, U. M. Granderath, Rudolph PointnerAbstract:Abstract Background Aerophagia is a rare but well-known comorbidity in patients with gastrooesophageal reflux disease. Particularly after laparoscopic Nissen fundoplication, it has proven to result in worse symptomatic outcome and a lower postoperative quality of life in comparison to patients without preoperative gas-related symptoms. Aims Aim of the study was to compare the postoperative outcome in gastrooesophageal reflux disease patients with Aerophagia as comorbidity after either laparoscopic 360° ‘floppy’ Nissen fundoplication or 270° Toupet fundoplication with main focus on the frequency and subjective impairment of gas-related symptoms. Patients and methods In 56 gastrooesophageal reflux disease patients, the comorbidity of Aerophagia was diagnosed prior to laparoscopic antireflux surgery. Irrespective of their preoperative manometric findings, the patients were either scheduled to a laparoscopic 360° ‘floppy’ Nissen (n = 28) or a laparoscopic 270° Toupet fundoplication (n = 28). All patients have been analysed concerning the presence of gas-related symptoms preoperatively as well as 3 months after surgery. Additionally, the subjective degree of impairment was evaluated using a numerous rating scale (0 = no perception/impairment, 100 = most severe perception/impairment). The following symptoms have been analysed: ability/inability to belch, ‘gas bloat’, flatulence, postprandial fullness and epigastric pain. Results Before surgery, there were no significant differences between both surgical groups. Three months after surgery, significant differences (p Conclusion Gas-related symptoms are very common in gastrooesophageal reflux disease patients with Aerophagia as a comorbidity. Patients who undergo a laparoscopic Toupet fundoplication show less impairment in relation to gas-related problems compared with patients treated with a Nissen fundoplication for a follow-up period of at least 3 months. In the Toupet group, the ability to belch postoperatively seems to be a positive aspect from the patients’ view which also improves the percentage of gas-related problems. However, long-term results are necessary.
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Comorbidity of Aerophagia in GERD patients: outcome of laparoscopic antireflux surgery.
Scandinavian journal of gastroenterology, 2002Co-Authors: T. Kamolz, T. Bammer, Frank A. Granderath, Rudolph PointnerAbstract:Background : While there is evidence that physiological data correlate poorly with quality-of-life data or patient-perceived symptom severity, most outcome studies of antireflux surgery still refer physiologic criteria. The aim of this prospective study was to establish whether concomitant Aerophagia in GERD (gastroesophageal reflux disease) patients might influence the surgical outcome of laparoscopic 'floppy' Nissen fundoplication. Methods : A total of 112 patients were divided into 2 subgroups: group 1 comprising GERD patients without Aerophagia ( n = 94; 84%); group 2 of GERD patients with concomitant Aerophagia ( n = 28; 16%). In all patients, requirements for surgery included an evaluation of symptoms (list of 17 symptoms; patients' grading from no - mild to moderate - severe), quality of life (Gastrointestinal Quality of Life Index: GIQLI), esophagogastroduodenoscopy, esophageal manometry and 24-h pH monitoring. Additionally, we asked for any potential stress relations to GERD symptoms. Surgical ou...
T. Kamolz - One of the best experts on this subject based on the ideXlab platform.
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gas related symptoms after laparoscopic 360 nissen or 270 toupet fundoplication in gastrooesophageal reflux disease patients with Aerophagia as comorbidity
Digestive and Liver Disease, 2007Co-Authors: Frank A. Granderath, T. Kamolz, U. M. Granderath, Rudolph PointnerAbstract:Abstract Background Aerophagia is a rare but well-known comorbidity in patients with gastrooesophageal reflux disease. Particularly after laparoscopic Nissen fundoplication, it has proven to result in worse symptomatic outcome and a lower postoperative quality of life in comparison to patients without preoperative gas-related symptoms. Aims Aim of the study was to compare the postoperative outcome in gastrooesophageal reflux disease patients with Aerophagia as comorbidity after either laparoscopic 360° ‘floppy’ Nissen fundoplication or 270° Toupet fundoplication with main focus on the frequency and subjective impairment of gas-related symptoms. Patients and methods In 56 gastrooesophageal reflux disease patients, the comorbidity of Aerophagia was diagnosed prior to laparoscopic antireflux surgery. Irrespective of their preoperative manometric findings, the patients were either scheduled to a laparoscopic 360° ‘floppy’ Nissen (n = 28) or a laparoscopic 270° Toupet fundoplication (n = 28). All patients have been analysed concerning the presence of gas-related symptoms preoperatively as well as 3 months after surgery. Additionally, the subjective degree of impairment was evaluated using a numerous rating scale (0 = no perception/impairment, 100 = most severe perception/impairment). The following symptoms have been analysed: ability/inability to belch, ‘gas bloat’, flatulence, postprandial fullness and epigastric pain. Results Before surgery, there were no significant differences between both surgical groups. Three months after surgery, significant differences (p Conclusion Gas-related symptoms are very common in gastrooesophageal reflux disease patients with Aerophagia as a comorbidity. Patients who undergo a laparoscopic Toupet fundoplication show less impairment in relation to gas-related problems compared with patients treated with a Nissen fundoplication for a follow-up period of at least 3 months. In the Toupet group, the ability to belch postoperatively seems to be a positive aspect from the patients’ view which also improves the percentage of gas-related problems. However, long-term results are necessary.
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Gas-related symptoms after laparoscopic 360° Nissen or 270° Toupet fundoplication in gastrooesophageal reflux disease patients with Aerophagia as comorbidity
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2007Co-Authors: Frank A. Granderath, T. Kamolz, U. M. Granderath, Rudolph PointnerAbstract:Abstract Background Aerophagia is a rare but well-known comorbidity in patients with gastrooesophageal reflux disease. Particularly after laparoscopic Nissen fundoplication, it has proven to result in worse symptomatic outcome and a lower postoperative quality of life in comparison to patients without preoperative gas-related symptoms. Aims Aim of the study was to compare the postoperative outcome in gastrooesophageal reflux disease patients with Aerophagia as comorbidity after either laparoscopic 360° ‘floppy’ Nissen fundoplication or 270° Toupet fundoplication with main focus on the frequency and subjective impairment of gas-related symptoms. Patients and methods In 56 gastrooesophageal reflux disease patients, the comorbidity of Aerophagia was diagnosed prior to laparoscopic antireflux surgery. Irrespective of their preoperative manometric findings, the patients were either scheduled to a laparoscopic 360° ‘floppy’ Nissen (n = 28) or a laparoscopic 270° Toupet fundoplication (n = 28). All patients have been analysed concerning the presence of gas-related symptoms preoperatively as well as 3 months after surgery. Additionally, the subjective degree of impairment was evaluated using a numerous rating scale (0 = no perception/impairment, 100 = most severe perception/impairment). The following symptoms have been analysed: ability/inability to belch, ‘gas bloat’, flatulence, postprandial fullness and epigastric pain. Results Before surgery, there were no significant differences between both surgical groups. Three months after surgery, significant differences (p Conclusion Gas-related symptoms are very common in gastrooesophageal reflux disease patients with Aerophagia as a comorbidity. Patients who undergo a laparoscopic Toupet fundoplication show less impairment in relation to gas-related problems compared with patients treated with a Nissen fundoplication for a follow-up period of at least 3 months. In the Toupet group, the ability to belch postoperatively seems to be a positive aspect from the patients’ view which also improves the percentage of gas-related problems. However, long-term results are necessary.
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Comorbidity of Aerophagia in GERD patients: outcome of laparoscopic antireflux surgery.
Scandinavian journal of gastroenterology, 2002Co-Authors: T. Kamolz, T. Bammer, Frank A. Granderath, Rudolph PointnerAbstract:Background : While there is evidence that physiological data correlate poorly with quality-of-life data or patient-perceived symptom severity, most outcome studies of antireflux surgery still refer physiologic criteria. The aim of this prospective study was to establish whether concomitant Aerophagia in GERD (gastroesophageal reflux disease) patients might influence the surgical outcome of laparoscopic 'floppy' Nissen fundoplication. Methods : A total of 112 patients were divided into 2 subgroups: group 1 comprising GERD patients without Aerophagia ( n = 94; 84%); group 2 of GERD patients with concomitant Aerophagia ( n = 28; 16%). In all patients, requirements for surgery included an evaluation of symptoms (list of 17 symptoms; patients' grading from no - mild to moderate - severe), quality of life (Gastrointestinal Quality of Life Index: GIQLI), esophagogastroduodenoscopy, esophageal manometry and 24-h pH monitoring. Additionally, we asked for any potential stress relations to GERD symptoms. Surgical ou...
