Twenty-four-hour pH monitoring is required to confirm acid reflux suppression in patients with Barrett's oesophagus undergoing anti-reflux surgery.

OBJECTIVE

To assess whether relief of gastro-oesophageal reflux symptoms in patients with Barrett's oesophagus who undergo laparoscopic anti-reflux surgery is a reliable indicator of acid suppression.

DESIGN

Prospective cohort study.

SETTING

Surgical department of a large district general hospital.

PARTICIPANTS

Twenty-two patients with Barrett's oesophagus and symptomatic gastro-oesophageal reflux who underwent laparoscopic anti-reflux surgery.

INTERVENTIONS: Laparoscopic anti-reflux surgery.

MAIN OUTCOME MEASURES: Postoperative symptom scores and 24-h pH test results.

RESULTS

Twenty-one out of 22 patients had no or minimal residual symptoms postoperatively (Visick I or II). DeMeester symptom scores improved from a median of 5 preoperatively to 0 postoperatively (P < 0.001, Mann-Whitney rank sum test). Eighteen out of 22 patients had postoperative pH studies: three had persisting abnormal acid exposure times postoperatively, but all three were asymptomatic.

CONCLUSIONS

In patients with Barrett's oesophagus, relief of reflux symptoms following laparoscopic anti-reflux surgery is unreliable as an indicator of acid reflux suppression.