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Delayed gastric emptying and its relationship to symptoms of "gas float" after antireflux surgery
L R Lundell1, J C Myers, G G Jamieson
1Department of Surgery, Royal Adelaide Hospital, University of Adelaide, Australia.
Objective:
To analyse the association between gastric motor function before and after operation and the development of symptoms of bloating after antireflux operations.
Design:
Open study.
Setting:
University department of surgery.
Subjects:
81 patients with long-standing severe gastro-oesophageal reflux before antireflux operations.
Interventions:
Gastric emptying of liquids and solids before (n = 81) and after (n = 47) antireflux operations.
Main Outcome Measures:
Pre- and postoperative gastric emptying times, and in reported symptoms of bloating and other postfundoplication complaints.
Results:
31 patients had fundoplication alone, 38 had highly selective vagotomy and fundoplication, and 12 had an Angelchik prosthesis inserted. Delayed gastric emptying of solids before operation was associated with symptoms of bloating (particularly postprandial pain and feeling sated) after operation. Delayed emptying of liquids correlated with transient symptoms only. Inability to belch and relieve bloating by belching were associated with postoperative delayed gastric emptying as well. There was no relationship between solid gastric emptying parameters and the final outcome of the operation as judged by the patients.
Conclusion:
Abnormalities of gastric motor function before operation are associated with symptoms of bloating after antireflux operations, and may therefore play a part in causing the symptoms.