Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 20 April 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Denervated stomach as an esophageal substitute recovers intraluminal acidity

Vagotomy initially decreases intraluminal gastric acidity in a large number of patients, however the stomach recovers a normal pH profile with time, according to research published in April's Annals of Surgery.

News image

fiogf49gjkf04

A team from Brussels, Belgium, and Cologne, Germany, determined whether the denervated stomach as an esophageal substitute recovers normal intraluminal acidity with time.

167 patients with transthoracic elevation of the stomach as esophageal replacement were included in the study.

One to 195 months after the procedure, 24-hour intraluminal gastric pH and bile were monitored in 91 and 76 patients, respectively.

9 patients underwent a second gastric pH monitoring 3 years after surgery.

The percentage of time that the gastric pH was less than 2, and bile absorbance exceeded 0.25, were calculated in reference to values from 25 healthy volunteers.

89 upper gastrointestinal endoscopies were performed in 83 patients.

Patients were divided into three groups, depending on length of follow-up: Group 1: less than 1 year; Group 2: 1 to 3 years; Group 3: more than 3 years.

The team found that the prevalence of a normal gastric pH profile was 32% in Group 1, 82% in Group 2, and 98% in Group 3.

The percentage of time that the gastric pH was less than 2 increased from Group 1 (27%) to Group 2 (56%) and Group 3 (71%), parallel to an increase in the prevalence of cervical heartburn and esophagitis.

Prevalence of normal gastric pH profile after vagotomy:
Less than 1 year: 32%
1 to 3 years : 82%
More than 3 years: 98%

Ann Surg

In addition, the percentage of time that the gastric pH was less than 2 increased from 29% to 81% in the 9 patients investigated twice.

Exposure of the gastric mucosa to bile was 13% in patients with a high gastric pH profile, versus 19% in those with normal acidity.

In the esophageal remnant in 6 patients, Barrett's metaplasia developed, intestinal (n = 2) or gastric (n = 4) in type.

Dr Christian Gutschow, of the University of Louvain, Brussels, said on behalf of he group, "Early after vagotomy, intraluminal gastric acidity is reduced in two-thirds of patients. However the stomach recovers a normal intraluminal pH profile with time, so that in more than one-third of patients, disabling cervical heartburn and esophagitis develop."

"The potential for the development of Barrett's metaplasia in the esophageal remnant brings into question the use of the stomach as an esophageal substitute in benign and early neoplastic disease," he concluded.

Ann Surg 2001; 233: 509-14
28 March 2001

Go to top of page Email this page Email this page to a colleague

 20 April 2018 
Obesity and physical activity in diverticulosis
 20 April 2018 
Worldwide H.pylori prevalence
 20 April 2018 
Adalimumab with azathioprine in Crohn's
 20 April 2018 
Antibody suitable for further clinical development to complement existing therapeutic strategies for HCV
 19 April 2018 
Fibrosis in patients with chronic hepatitis B
 19 April 2018 
c-Myc expression and pancreatic cancer
 19 April 2018 
Olmesartan prescription in the USA
 18 April 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 18 April 2018 
Hep C treatment for sustained virologic response
 18 April 2018 
Endoscopic necrosectomy reduces risk of death 
 17 April 2018 
Colorectal cancer screening and ethnic inequities
 17 April 2018 
Training programs should consider radiation education for advanced endoscopy fellows
 17 April 2018 
Aspirin and pancreatic cancer
 16 April 2018 
Surgery for colorectal polyps has increased 
 16 April 2018 
Advanced fibrosis can be ruled out in primary health care patients
 16 April 2018 
Antibiotic use and colorectal adenoma
 13 April 2018 
Colorectal cancer cell lines
 13 April 2018 
Infliximab and corticosteroid-free clinical remission in Crohn's
 13 April 2018 
Teduglutide for children with short bowel syndrome
 12 April 2018 
Prescriptions for opiate drugs amongst primary care patients with IBD
 12 April 2018 
Lower GI bleeding related to comorbidity
 12 April 2018 
non–Clostridium difficile bacterial infections in IBD
 11 April 2018 
Physician perception of IBD trial results
 11 April 2018 
Bile acid deficiency in IBS 
 11 April 2018 
Stem cell therapy for fistulas in Crohn's
 10 April 2018 
Overweight in childhood and type 2 diabetes
 10 April 2018 
immunoglobulin G associates with clinical features of IBD
 10 April 2018 
T-cells repertoires in celiac disease
 09 April 2018 
Biomarker tests for colorectal cancer screening
 09 April 2018 
Fecal transplantation in C. difficile infection and treatment outcome 
 09 April 2018 
No weigh-loss drug improved all cardiometabolic risk factors
 06 April 2018 
Colonoscopy and colorectal cancer mortality
 06 April 2018 
Eosinophilic esophagitis and health-related quality of life
 06 April 2018 
Microbiome in athletes vs sedentary subjects
 05 April 2018 
Laparoscopic Nissen fundoplication for GERD treatment
 05 April 2018 
Random biopsies for neoplasia in IBD
 05 April 2018 
Scoring system identifies cancer risk in Barrett's
 04 April 2018 
Alpha‐1 antitrypsin deficiency and liver disease
 04 April 2018 
PPI and risk of stroke
 04 April 2018 
Adjuvant chemotherapy for advanced colon cancer
 29 March 2018 
Prevention of metachronous gastric cancer
 29 March 2018 
Acute lower GI bleeding
 28 March 2018 
Decision aid used by IBD patients
 28 March 2018 
Transition for young adults with IBD
 28 March 2018 
Amitriptyline in functional dyspepsia
 27 March 2018 
Emergency department utilization for IBD 
 27 March 2018 
Management of hemorrhoids in the USA
 27 March 2018 
Adult ulcerative colitis
 26 March 2018 
Biological therapy response in IBD 
 26 March 2018 
Obesity and diverticulosis
 26 March 2018 
Practice guidelines for chronic constipation
 23 March 2018 
Health-related quality of life in eosinophilic esophagitis
 23 March 2018 
Genetics and chronic liver disease
 23 March 2018 
Global prevalence of H.pylori
 22 March 2018 
H. pyloris and gastric cancer
 22 March 2018 
Pancreatitis after IBS treatment 
 22 March 2018 
Mechanisms of action in patients with IBS
 21 March 2018 
Panel markers for early detection of colon cancer

 21 March 2018 
Blood test differentiates celiac disease
 21 March 2018 
Patient characteristics and colonoscopy preparation

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us