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Gastric Function After Fundoplication

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Pediatric Neurogastroenterology

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Fundoplication is a common operation in children. Even though it is very successful to control gastroesophageal reflux, it can be associated with significant postoperative symptoms that may limit its effectiveness. Fundoplication reduces the volume of the stomach and uses most of the proximal stomach to create a wrap around the lower part of the esophagus, thus affecting the gastric sensorimotor function. Studies consistently show that it may increase the rate of gastric emptying, decrease gastric accommodation, lead to impaired distribution of intragastric food with the ingested material reaching and distending the distal stomach much earlier than physiologically expected, and also produce visceral hypersensitivity. Postoperative symptoms that may be attributed to gastric sensorimotor dysfunction after surgery include inability to belch, early satiety, bloating, dyspepsia, gas-bloat syndrome, retching, pain, feeding refusal, diarrhea, and dumping. Given that the symptoms can originate from a variety of underlying etiologies, it is important to understand the pathophysiology of the symptoms in each patient, to be able to tailor therapy accordingly.

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References

  1. Fonkalsrud EW, Ashcraft KW, Coran AG, Ellis DG, Grosfeld JL, Tunell WP, et al. Surgical treatment of gastroesophageal reflux in children: a combined hospital study of 7467 patients. [comment]. Pediatrics. 1998;101(3 (Pt 1)):419–22.

    Article  PubMed  CAS  Google Scholar 

  2. Di Lorenzo C, Orenstein S. Fundoplication: friend or foe? J Pediatr Gastroenterol Nutr. 2002;34:117–24.

    Article  PubMed  Google Scholar 

  3. Mousa H, Caniano DA, Alhajj M, Gibson L, Di Lorenzo C, Binkowitz L. Effect of Nissen fundoplication on gastric motor and sensory functions. J Pediatr Gastroenterol Nutr. 2006;43(2):185–9.

    Article  PubMed  Google Scholar 

  4. Nurko SS. Complications after gastrointestinal surgery. A medical perspective. In: Walker WA et al., editors. Pediatric gastrointestinal disease. 3rd ed. Philadelphia: B.C. Decker Inc.; 2004. p. 2111–38.

    Google Scholar 

  5. Stanghellini V, Malagelada JR. Gastric manometric abnormalities in patients with dyspeptic symptoms after fundoplication. Gut. 1983;24(9):790–7.

    Article  PubMed  CAS  Google Scholar 

  6. Zangen T, Ciarla C, Zangen S, Di Lorenzo C, Flores AF, Cocjin J, et al. Gastrointestinal motility and sensory abnormalities may contribute to food refusal in medically fragile toddlers. J Pediatr Gastroenterol Nutr. 2003;37(3):287–93.

    Article  PubMed  Google Scholar 

  7. Wijnhoven BP, Salet GA, Roelofs JM, Smout AJ, Akkermans LM, Gooszen HG. Function of the proximal stomach after Nissen fundoplication. Br J Surg. 1998;85(2):267–71.

    Article  PubMed  CAS  Google Scholar 

  8. Vu MK, Ringers J, Arndt JW, et al. Prospective study of the effect of laparoscopic hemifundoplication on motor and sensory function of the proximal stomach. Br J Surg. 2000;87:338–43.

    Article  PubMed  CAS  Google Scholar 

  9. Bouras EP, Delgado-Aros S, Camilleri M, Castillo EJ, Burton DD, Thomforde GM, et al. SPECT imaging of the stomach: comparison with barostat, and effects of sex, age, body mass index, and fundoplication. Single photon emission computed tomography. Gut. 2002; 51(6):781–6.

    Article  PubMed  CAS  Google Scholar 

  10. Remes-Troche JM, Montano-Loza A, Martinez JC, Herrera M, Valdovinos-Diaz MA. Drinking capacity and severity of dyspeptic symptoms during a water load test after Nissen fundoplication. Dig Dis Sci. 2007;52(10):2850–7.

    Article  PubMed  Google Scholar 

  11. Mertz H, Fullerton S, Naliboff B, Mayer EA. Symptoms and visceral perception in severe functional and organic dyspepsia. Gut. 1998;42(6):814–22.

    Article  PubMed  CAS  Google Scholar 

  12. DeVault KR, Swain JM, Wentling GK, Floch NR, Achem SR, Hinder RA. Evaluation of vagus nerve function before and after antireflux surgery. J Gastrointest Surg. 2004;8(7):883–8. discussion 8–9.

    Article  PubMed  Google Scholar 

  13. Lindeboom MY, Ringers J, van Rijn PJ, Neijenhuis P, Stokkel MP, Masclee AA. Gastric emptying and vagus nerve function after laparoscopic partial fundoplication. Ann Surg. 2004;240(5):785–90.

    Article  PubMed  Google Scholar 

  14. Farrell TM, Richardson WS, Halkar R, Lyon CP, Galloway KD, Waring JP, et al. Nissen fundoplication improves gastric motility in patients with delayed gastric emptying. Surg Endosc. 2001; 15(3):271–4.

    Article  PubMed  CAS  Google Scholar 

  15. Hinder RA, Stein HJ, Bremner CG, DeMeester TR. Relationship of a satisfactory outcome to normalization of delayed gastric emptying after Nissen ­fundoplication. Ann Surg. 1989;210(4):458–64. discussion 64–5.

    Article  PubMed  CAS  Google Scholar 

  16. Borovoy J, Furuta L, Nurko S. Benefit of uncooked corn starch in the management of children with dumping syndrome fed exclusively by gastrostomy. Am J Gastroenterol. 1998;93:814–8.

    Article  PubMed  CAS  Google Scholar 

  17. Samuk I, Afriat R, Horne T, Bistritzer T, Barr J, Vinograd I. Dumping syndrome following Nissen fundoplication, diagnosis, and treatment. J Pediatr Gastroenterol Nutr. 1996;23(3):235–40.

    Article  PubMed  CAS  Google Scholar 

  18. DiLorenzo C, Flores A, Hyman PE. Intestinal motility in symptomatic children with fundoplication. J Pediatr Gastroenterol Nutr. 1991;12:169–73.

    Article  CAS  Google Scholar 

  19. Richards CA, Andrews PL, Spitz L, Milla PJ. Nissen fundoplication may induce gastric myoelectrical ­disturbance in children. J Pediatr Surg. 1998; 33(12):1801–5.

    Article  PubMed  CAS  Google Scholar 

  20. Klaus A, Hinder RA, DeVault KR, Achem SR. Bowel dysfunction after laparoscopic antireflux surgery: incidence, severity, and clinical course. Am J Med. 2003;114(1):6–9.

    Article  PubMed  Google Scholar 

  21. Scheffer RC, Tatum RP, Shi G, Akkermans LM, Joehl RJ, Kahrilas PJ. Reduced tLESR elicitation in response to gastric distension in fundoplication patients. Am J Physiol Gastrointest Liver Physiol. 2003;284(5):G815–20.

    PubMed  CAS  Google Scholar 

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Acknowledgement

Supported by grant NIH K24DK082792A.

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Authors and Affiliations

  1. Center for Motility and Functional Gastrointestinal Disorders, Children’s Hospital Boston, 300 Longwood Ave, Boston, MA, 02155, USA

    Samuel Nurko M.D., M.P.H.

Authors
  1. Samuel Nurko M.D., M.P.H.
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Correspondence to Samuel Nurko M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. Sainte-Justine Hospital, Department of Pediatrics, Division of Pediatric Gastroenterology, Université de Montréal, Montreal, H3T 1C5, Québec, Canada

    Christophe Faure

  2. Nationwide Children's Hospital, Division of Pediatric Gastroenterology, The Ohio State University, Columbus, 43205, Ohio, USA

    Carlo Di Lorenzo

  3. Gastroenterology and Neural Development, University College London, Institute of Child Health, Great Ormond Street Hospital for Children, London, WC1N 1EH, United Kingdom

    Nikhil Thapar

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Nurko, S. (2013). Gastric Function After Fundoplication. In: Faure, C., Di Lorenzo, C., Thapar, N. (eds) Pediatric Neurogastroenterology. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-709-9_28

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  • DOI: https://doi.org/10.1007/978-1-60761-709-9_28

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-708-2

  • Online ISBN: 978-1-60761-709-9

  • eBook Packages: MedicineMedicine (R0)

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