DELAYED GASTRIC-EMPTYING AND ITS RELATIONSHIP TO SYMPTOMS OF GAS-BLOAT AFTER ANTIREFLUX SURGERY

Objective: To analyse the association between gastric motor function b efore and after operation and the development of symptoms of bloating after antireflux operations. Design: Open study. Setting: University d epartment 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 postoperat ive gastric emptying times, and in reported symptoms of bloating and o ther postfundoplication complaints. Results: 31 patients had fundoplic ation alone, 38 had highly selective vagotomy and fundoplication, and 12 had an Angelchik prosthesis inserted. Delayed gastric emptying of s olids before operation was associated with symptoms of bloating (parti cularly 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 postop erative delayed gastric emptying as well. There was no relationship be tween solid gastric emptying parameters and the final outcome of the o peration as judged by the patients. Conclusion: Abnormalities of gastr ic motor function before operation are associated with symptoms of blo ating after antireflux operations, and may therefore play a part in ca using the symptoms.