title: Gas-related symptoms after antireflux surgery.
abstract: BACKGROUND
  Gas-related symptoms such as bloating, flatulence, and impaired ability to belch are frequent after antireflux surgery, but it is not known how these symptoms affect patient satisfaction with the procedure or what determines the severity of these complaints. We aimed to assess the impact of gas-related symptoms on patient-perceived success of surgery and to determine whether the severity of gas-related complaints after antireflux surgery is associated with objectively measured abnormalities.
  
  
  METHODS
  Fifty-two patients were studied at a median of 27 months after antireflux surgery. The influence of gas-related symptoms on their quality of life and satisfaction with surgical outcome was assessed. The rates of air swallows and gastric and supragastric belches before and after surgery were assessed using impedance measurements.
  
  
  RESULTS
  Bloating and flatulence were associated with a decreased quality of life and less satisfaction with surgical outcome. Notably, 9 % of the patients would not opt for surgery again due to gas-related symptoms. Antireflux surgery decreased the total number of gastric belches but did not affect the number of air swallows. The severity of gas-related symptoms was not associated with an increased number of preoperative air swallows and/or belches or a larger postoperative decrease in the number of gastric belches.
  
  
  CONCLUSIONS
  Gas-related symptoms are associated with less satisfaction with surgical outcome. The severity of gas-related symptoms is not determined by the number of preoperative air swallows or a more severe impairment of the ability to belch after surgery. Preoperative predictors of postoperative gas-related symptoms therefore could not be identified.
authors: Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, b.f.kessing@amc.uva.nl.
authors: Boudewijn F
authors: BF
authors: Kessing
authors: Joris A J L
authors: JA
authors: Broeders
authors: Nikki
authors: N
authors: Vinke
authors: Marlies P
authors: MP
authors: Schijven
authors: Eric J
authors: EJ
authors: Hazebroek
authors: Ivo A M J
authors: IA
authors: Broeders
authors: Albert J
authors: AJ
authors: Bredenoord
authors: André J P M
authors: AJ
authors: Smout
mesh_terms: D000328:Adult; D000334:Aerophagy; D000368:Aged; D017097:Electric Impedance; D004884:Eructation / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology; D005260:Female; D005414:Flatulence / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D005740:Gases; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index
chemical_list: D005740:Gases
references: Dis Esophagus. 2009;22(1):84-8
references: 19018854
references: Gut. 1990 Jun;31(6):639-46
references: 2379867
references: Ann Surg. 2012 Jan;255(1):59-65
references: 22167002
references: Am J Gastroenterol. 2009 Aug;104(8):1992-7
references: 19455107
references: Gastroenterology. 2002 Jun;122(7):1748-55
references: 12055580
references: JAMA. 2011 May 18;305(19):1969-77
references: 21586712
references: Surg Endosc. 2005 Dec;19(12):1579-87
references: 16211438
references: Am J Gastroenterol. 2006 Nov;101(11):2470-5
references: 17090278
references: N Engl J Med. 1975 Sep 11;293(11):524-6
references: 1152877
references: J Gastrointest Surg. 2006 Nov;10(9):1312-6; discussion 1316-7
references: 17114017
references: J R Coll Surg Edinb. 1977 Nov;22(6):391-4
references: 604461
references: N Engl J Med. 2008 Oct 16;359(16):1700-7
references: 18923172
references: Gastroenterology. 1998 Sep;115(3):542-50
references: 9721151
references: Cochrane Database Syst Rev. 2010 Mar 17;(3):CD003243
references: 20238321
references: Med Care. 1996 Mar;34(3):220-33
references: 8628042
references: Aliment Pharmacol Ther. 2011 Mar;33(6):650-61
references: 21219371
references: Surg Endosc. 2010 Nov;24(11):2647-69
references: 20725747
references: Gut. 2001 Jan;48(1):14-9
references: 11115817
references: Gut. 2005 Mar;54(3):344-8
references: 15710981
references: JAMA. 2001 May 9;285(18):2331-8
references: 11343480
references: J Gastrointest Surg. 2002 Jul-Aug;6(4):632-7
references: 12127133
references: Br J Surg. 2010 Sep;97(9):1318-30
references: 20641062
references: Eur J Gastroenterol Hepatol. 2000 Aug;12(8):879-87
references: 10958215
references: Gut. 2008 Feb;57(2):161-6
references: 17895353
references: Lancet. 2000 Jan 15;355(9199):170-4
references: 10675115
references: Gut. 2004 Nov;53(11):1561-5
references: 15479671
references: Gut. 2011 Apr;60(4):435-41
references: 21193452
references: Aliment Pharmacol Ther. 2012 May;35(9):1073-9
references: 22428801
references: Am J Gastroenterol. 1999 May;94(5):1320-6
references: 10235213
references: Gut. 2004 Jul;53(7):1024-31
references: 15194656
references: Interact Cardiovasc Thorac Surg. 2012 Jun;14(6):828-33
references: 22392936
references: Schweiz Med Wochenschr. 1956 May 18;86(Suppl 20):590-2
references: 13337262
references: Am J Physiol Gastrointest Liver Physiol. 2001 Jul;281(1):G138-43
references: 11408265