Upper GI symptoms are commonly associated with obstructed defaecation syndrome and frequently respond to anti-prolapse surgery: P012

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Aim:Upper GI symptoms (UGIS, chest pain, heartburn, regurgitation, reflux) have a known association with IBS. There is substantial overlap in Rome III criteria for IBS and chronic constipation and at > 30% of patients with obstructed defaecation syndrome (ODS) have a diagnosis of IBS1.We describe apreviously unreported relationship between UGIS and ODS.Method:UGIS (particularly reflux) were documented in patients with ODS. Those undergoing antiprolapse surgery were assessed for resolution of symptoms. A subgroup went on to have upper GI physiology studies (UGIP). The influence of symptom severity and colonic transit time (CTT) onpresence and resolution of UGIS was analysed.Results:129/202 patients (64%) complained of UGIS. 23/33 patients (70%) reported improved UGIS after ventral rectopexy. Median Wexner score in those with and without UGIS (14 vs 13) and improved or not after surgery (14 vs 15) was similar. CTT was slower in those without UGIS (49.2 vs 36.0 hrs) and in those improved after surgery (45.6 vs 28.8). All had normal manometry, but only half had objective evidence of oesophageal reflux.Conclusion:Upper GI symptoms are commonly associated with ODS and frequently respond to antiprolapse surgery. The mechanism for this is unclear.1Wijffels et al Colorectal Dis 2008 [abst]

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