Implications of upright gastro-oesophageal reflux

The presentation, oesophageal profile and management of 27 symptomatic patients with daytime (upright) gastro-oesophageal reflux only is reported. Oesophagitis was a presenting feature in 11 patients and its development was most closely correlated with postprandial reflux, which was characterized by cumulative acid exposure rather than by clearance abnormalities. Upright reflux was not associated with a hypotensive lower oesophageal sphincter or with oesophageal dysmotility. Antireflux surgery is indicated when conservative measures fail and was not associated with gas-bloat syndrome after operation.