Dr Kenneth DeVault and colleagues from Jacksonville, Florida undertook a study that sought to evaluate vagus nerve integrity before and after antireflux surgery and to compare it with symptomatic outcome.
The research group recruited antireflux surgery patients and excluded patients with disorders associated with vagus dysfunction or who took medications with anticholinergic effects.
Each patient underwent a sham-feeding−stimulated pancreatic polypeptide (PP) test before and after surgery.
|Some patients referred for antireflux surgery have evidence of abnormal vagus function that persists after surgery|
|Journal of Gastrointestinal Surgery|
The researchers also administered a symptom survey.
The researchers included a total of 20 patients who had completed preoperative testing; their mean age was 57 years, and postoperative testing results were available for 16 of them.
The research team found that out of the 20, 14 (70%) had an appropriate increase in PP level with sham-meal preoperatively.
In addition, the research group noted that all 4 patients with an abnormal preoperative test remained abnormal, and 5 of 12 (42%) with a normal preoperative test had an abnormal postoperative result.
So 9 of 16 (56%) had an abnormal postoperative PP test.
In 15 patients, the researchers obtained assessments of bowel function before and after surgery.
6 of 15 (40%) patients developed new or worse symptoms (diarrhea in 4, flatus in 2).
The group noted that the symptoms did not correlate with PP results.
Dr DeVault concluded, "This suggests that some patients referred for antireflux surgery have evidence of abnormal vagus function that persists after surgery."
"Many patients (42%) with normal testing before surgery develop an abnormal test after surgery."
He added, "There was no correlation between PP tests and the development or worsening of bowel symptoms."