Premium
Impact of laparoscopic antireflux surgery on belching in pediatric GERD patients
Author(s) -
Rinsma N. F.,
Mauritz F. A.,
Heurn L. W. E.,
Sloots C. E. J.,
Siersema P. D.,
Houwen R. H. J.,
Zee D. C.,
Masclee A. A. M.,
Conchillo J. M.,
Van HerwaardenLindeboom M. Y. A.
Publication year - 2016
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12850
Subject(s) - gerd , medicine , general surgery , gastroenterology , surgery , disease , reflux
Background Laparoscopic antireflux surgery ( LARS ) is a well‐established treatment option for children with proton pomp inhibitor ( PPI )‐resistant gastroesophageal reflux disease ( GERD ). Besides preventing reflux of gastric fluid and solid content, LARS may also impair the ability of the stomach to vent intragastric air (i.e. gastric belching) and induce gas‐related complications, such as bloating and/or hyperflatulence. Furthermore, it was previously hypothesized that LARS induces a behavioral type of belching, not originating from the stomach, called supragastric belching. The aim of this study was to objectively evaluate the impact of LARS on gastric ( GB ) and supragastric belching ( SGB ) in children with GERD . Methods We performed a prospective, Dutch multicenter cohort study including 25 patients (12 males, median age 6 (range 2–18) years) with PPI ‐resistant GERD who were scheduled for LARS . Twenty‐four‐hour multichannel intraluminal impedance pH monitoring ( MII ‐ pH monitoring) was performed before and 3 months after fundoplication. Impedance pH tracings were analyzed for reflux episodes and GB s and SGBs. Key Results LARS reduced acid exposure time from 8.5% (6.0–16.2%) to 0.8% (0.2–2.8%), p < 0.001. The number of GB s also significantly decreased after LARS (59 [43–77] VS 5 [2–12], p < 0.001). The number of air swallows remained unchanged after LARS . SGB s were infrequent before LARS with no change in the number of SGB observed after the procedure. Postoperative belching symptoms were associated with GB s, not with SGB s. Conclusion & Inferences LARS significantly reduces the number of GB s in children with GERD , whereas the number of air swallows remains unchanged. Postoperative symptomatic belching is associated with GB s, but not with SGB s. These findings suggest that LARS does not induce the occurrence of SGB s in children, but longer follow‐up is required.