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Why Acid Reflux Is Common After Esophagectomy: What Saliva Tests Reveal

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The Trajectory of Reflux and its Associating Factors in Patients After Esophagectomy Based on Salivary Pepsin-Testing A Prospective Longitudinal Study DOI- 10.1245s1043

Many people who have surgery for esophageal cancer experience reflux afterward. This study looked at a new way to measure reflux using a simple saliva test. The goal was to better understand when reflux happens and what can help reduce it.

Over 200 patients were followed for six months after surgery. They gave saliva samples before surgery and at different times after surgery. These samples were tested for pepsin, a substance that shows if stomach acid is coming up into the throat.

Reflux got worse during the first month after surgery, then slowly got better. People who had high pepsin levels before surgery continued to have more reflux, even after surgery.

The study found two helpful habits that reduced reflux:

⦿ Sleeping with your upper body raised (semi-Fowler position)

⦿ Not eating for at least two hours before going to bed

People who did these things regularly had lower reflux levels. On the other hand, if the new stomach tube created during surgery was too long or loose (called “redundancy of conduit”), reflux was worse.

This saliva test helped doctors see which patients had more acid going into their throat. More importantly, it showed that small lifestyle changes can help reduce reflux symptoms.

If you’ve had surgery for esophageal cancer and are struggling with reflux, try raising your upper body while resting and avoid eating close to bedtime. These simple changes can make a big difference.

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Dr Harsh Shah - GI & HPB Oncosurgeon in Ahmeadbad
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