Gastro-oesophageal acid reflux in patients with symptomatic hiatus hernia and effect of a modified Belsey MK IV repair on acid reflux
Boesby, S.
Scandinavian Journal of Gastroenterology 12(5): 553-569
1977
ISSN/ISBN: 0036-5521 PMID: 21444 Document Number: 118288
Continuous (12 h) recording of pH at the distal end of the esophagus was carried out in 59 patients with sliding hiatus hernia and symptoms suggestive of gastro-esophageal reflux, and the results were compared with those obtained in normal subjects. Mean duration of pH .ltoreq. 2.3, pH .ltoreq. 3, pH .ltoreq. 4 and pH .ltoreq. 5, expressed in percentages of the total time of recording, was longer in patients than in normal subjects. There was no difference in mean number of reflux episodes between patients and normal subjects. The clearest separation between the 2 groups was obtained by the variable duration of pH .ltoreq. 5. Irrespective of the variable used, the results did not seem to be related to the degree of severity of the symptoms. Individual sensitivity of the esophageal mucosa, the content of bilious components in the refluxed material and the semi-quantitative character of the investigation may, in part, account for the results. The same investigation was carried out before and 3 mo. after a modified Belsey MK IV repair in 39 patients with hiatus hernia and symptoms indicating surgical treatment. The operation was followed by a reduction in the tendency to acid reflux, probably as a result of an increase in the competence of the gastro-esophageal region.