XXXX do not correlate with objective pH testing after peroral endoscopic myotomy.

@entity1318 @entity1 @entity86 @entity354 @entity1282
INTRODUCTION: Peroral endoscopic myotomy (POEM) is an emerging treatment for @entity1318 . @entity86 has been found in a significant number of @entity1 , but it is unknown whether subjective reports of reflux correlate with objective pH testing. The purpose of this study was to compare the objective rate of reflux with standardized reflux symptom scales after POEM. Our hypothesis was that subjective symptoms would not correlate with objective measurement of reflux. METHODS AND PROCEDURES: Data on all @entity1 undergoing POEM were collected prospectively between August 2012 and June 2014 and included demographics, objective testing (48-h pH probe, manometry, endoscopy), as well as @entity354 ( @entity354 ), GERD symptom scale (GERSS), and antacid use. RESULTS: Forty-three @entity1 underwent POEM during the study period. The mean age was 53.5      17.4  years with a BMI of 29.6      8.4  kg/m(2), and 27 (63%) were male. Forty-two @entity1 (98%) completed at least 6  months of follow-up, and 26 (60%) underwent repeat pH measurement. @entity1282 scores improved from 4 (0-5) at baseline to 0 (0-3) (p  <  0.001). On follow-up pH testing, 11 (42%) were normal and 15 (58%) had elevated DeMeester scores. Postoperative GERSS or @entity354 scores did not correlate with DeMeester scores on Spearman's rank-order tests (r  =  0.02, p  =  0.93 and r  =  0.04, p  =  0.50, respectively). Postoperative PPI use was not significantly associated with normal or abnormal pH testing: 5 of 7 (71%) @entity1 who were taking PPIs postoperatively had abnormal DeMeester scores compared to 9 of 18 (50%) of @entity1 who were not taking PPIs (p  =  0.332). CONCLUSIONS: Peroral endoscopic myotomy provides excellent @entity1282 relief for @entity1 with @entity1318 , but is associated with a high rate of reflux on pH testing postoperatively. Subjective symptoms are not a reliable indicator of postoperative reflux. Routine pH testing should be considered in all @entity1 following POEM.
