pH Monitoring Research Articles

Dual-Needle Field-Effect Transistor Biosensor for In Vivo pH Monitoring.

Local pH of the brain microenvironment is a prominent indicator for assessing health status and is closely related to many diseases; therefore, the development of effective in vivo pH methods is of great importance. This work demonstrates a dual-needle biosensor based on a solution-gate field-effect transistor (FET) for selective and sensitive monitoring of pH in cerebrospinal fluid in the central nervous system. The sensor consists of two parts: a needle FET modified with high-purity carbon nanotubes for electrical signal conduction and a needle gate modified with polyaniline for specific pH response. Based on the device's specific shape and sensing characteristics, the dual-needle sensor is sensitive to the measurement of pH in the living brain while maintaining excellent stability. The prepared dual-needle biosensor exhibits a high Nernstian response of 53.7 mV/pH over a wide pH range from 4.0 to 9.0 and excellent selectivity toward pH against other potential interfering species in the brain. Either in the case of directly injecting weak acids and bases into the rat brain or in the constructed acute acid-base poisoning model, the dual-needle biosensor can respond sensitively to the pH changes of the rat brain. This work has produced a unique dual-needle FET biosensor with high reliability and stability, which provides a new method for real-time monitoring of dynamic pH changes in the body.

Study on the sterilization effect of plasma jet and plasma activated water on Streptococcus mutans

To explore the effects of plasma jet (PJ) and plasma activated water (PAW) on the sterilization of Streptococcus mutans ( S. mutans) and compare the advantages and disadvantages of the two methods, so as to provide a basis for plasma treatment of dental caries and to enrich the treatment means of dental caries, an atmospheric pressure plasma excitation system was built, and the effects of PJ and PAW on the sterilization rate of S. mutans and the changes of temperature and pH during treatment were studied under different excitation voltage ( U e ) and different excitation time ( t e ). The results showed that in the PJ treatment, the difference in the survival rate of S. mutans between the treatment group and the control group was statistically significant ( P = 0.007, d=2.66) when U e = 7 kV and t e = 60 s, and complete sterilization was achieved at U e = 8 kV and t e = 120 s in the PJ treatment. In contrast, in the PAW treatment, the difference in the survival rate of S. mutans between the treatment group and the control group was statistically significant ( P = 0.029, d = 1.71) when U e = 7 kV and t e = 30 s, and complete sterilization was achieved with PAW treatment when U e = 9 kV and t e = 60 s. Results of the monitoring of temperature and pH showed that the maximum temperature rise during PJ and PAW treatment did not exceed 4.3 °C, while the pH value after PAW treatment would drop to a minimum of 3.02. In summary, the optimal sterilization parameters for PJ were U e =8 kV and 90 s < t e ≤ 120 s, while the optimal sterilization parameters for PAW were U e = 9 kV and 30 s< t e ≤ 60 s. Both treatment methods achieved non-thermal sterilization of S. mutans, where PJ required only a smaller U e to achieve complete sterilization, while at pH < 4.7, PAW only required a shorter t e to achieve complete sterilization, but its acidic environment could cause some chemical damage to the teeth. This study can provide some reference value for plasma treatment of dental caries.

Optical In Situ Monitoring of Acid Mine Drainage Remediation: Laboratory and Model Investigation

AbstractA permeable reactive barrier (PRB) can be deployed to remediate acid mine drainage. The performance of a PRB material under different boundary conditions (pH, flow velocity, and sulfate concentration) was investigated in a series of column experiments applying in‐situ optical sensing methods for pH and oxygen detection. The reactive material consisted of organic components (compost, wood, and coconut shell) mixed with calcium carbonate and fine gravel. The input concentrations were around 1000 mg/L for iron and 3000 mg/L for sulfate, and the pH value was 6.2. The remediation efficiency of iron was 14.6% and of sulfate 15.2%, but was expected to scale up when moving to a field‐site PRB with greater thickness. The iron and sulfate removal was influenced by decreasing the flow velocity and increasing the sulfate input concentration and the pH value. In an experiment with low pH boundary conditions (pH = 2.2), acidity was neutralized in the PRB by calcium carbonate during an experiment duration of 47 days. The modeling program MIN3P was used to create a simulation of the laboratory experiments. This helps to design parameters, for example, the residence time in the PRB, which is necessary for close to 100% remediation efficiency. This study shows the application of optical oxygen and pH monitoring in PRBs. In this context, they can be used to monitor the stability of a PRB for the remediation of acid mine drainage (AMD).

Preoperative patient factors and anatomy do not predict who will develop reflux after per oral endoscopic myotomy.

Per oral endoscopic myotomy (POEM) has been shown to be an efficacious and safe therapy for the treatment of achalasia. Compared to laparoscopic Heller myotomy however, no antireflux procedure is routinely combined with POEM and therefore the development of symptomatic or silent reflux is of concern. This study was designed to determine if various patient factors and anatomy would predict the development of gastroesophageal reflux disease post-operatively. This was a retrospective cohort study of all patients who underwent a POEM at a single institution by a single surgeon over an eight-year period (2014-2022). It has been our practice to obtain a postoperative ambulatory pH test on all patients 6months after POEM off all acid reducing medications. Patients without a postoperative ambulatory esophageal pH monitoring test were excluded. Age, sex, obesity (BMI > 30), achalasia type, presence of a hiatal hernia, history of prior endoscopic achalasia treatments or myotomy were analyzed using univariate analysis as predictive factors for the development of postoperative GERD (DeMeester score > 14.7 on ambulatory pH monitoring). There were 179 total patients included in the study with 42 patients (23.5%) having undergone postoperative ambulatory pH testing. The majority of patients (137 or 76.5%) were lost to follow up and did not undergo ambulatory pH testing. Twenty-three out of those 42 patients (55%) had evidence of GERD on ambulatory pH testing. Multiple preoperative patient characteristics including demographics, manometric results, EGD findings, and history of prior achalasia interventions did not correlate with the development of post-operative GERD. Despite the high rate of reflux after POEM, there does not appear to be any reliable preoperative indicators of which patients have a higher risk of developing post-operative GERD after POEM.

Measurement of oesophageal hiatus surface area by multiplanar reconstruction of MDCT: relationship with lower oesophageal sphincter pressure and acid reflux

To evaluate the relationship between oesophageal hiatus surface area (OHSA) and gastro-oesophageal reflux disease (GERD). Patients who underwent 24-h pH monitoring, oesophageal high-resolution manometry, and upper abdominal contrast-enhanced multidetector computed tomography (MDCT) during 2014-2021 were enrolled. Patients with a hiatus hernia (HH) on MDCT or who had a history of gastro-oesophageal surgery were excluded. Multiplanar reconstruction (MPR) of the MDCT image was used for the measurement of OHSA. Correlations of OHSA with acid exposure time (AET) and lower oesophageal sphincter (LOS) pressure of all patients were analysed. Seventy-eight patients were included in the study. OHSA was much less in the AET <4% group than in the AET >6% group (1.61±0.42 versus 2.09±0.55 cm2, p<0.001). Correlation analysis reveals that OHSA correlated positively with AET (correlation coefficient=0.47, p<0.001). Receiver operating characteristic (ROC) curve analysis reveals that OHSA can significantly distinguish patients in different groups divided by AET (area under the ROC curve [AUC]=0.76, 95% confidence interval [CI]: 0.63-0.90). OHSA was not related to LOS pressure (correlation coefficient=-0.268, p=0.051). There was no difference in OHSA between the low LOS pressure group and the normal LOS pressure group (1.84±0.61 versus 1.74±0.50 cm2, p=0.52). OHSA significantly correlated with AET but has no relationship with LOS pressure. It may be an independent risk factor of GERD.

Highly Sensitive Physiological Sensor Based on Tapered Fiber-Optic Interferometer for Sweat pH Detection

The pH value of human sweat correlates with metabolic activities and diseases. Precise sweat pH sensing can serve as a health-profiling strategy. This study demonstrates a compact fiber-optic sweat pH sensor that contains an optimized conical structure coated with polyelectrolyte membrane as the pH sensitive layer. To functionalize the tapered sensing area for pH monitoring, chitosan/polyacrylic acid (PAA) polyelectrolytes are deposited as pH-sensitive membranes. As the swelling degree of the sensing film depends on the pH value, the tapered fiber-optic sensor based on the Mach-Zehnder interferometer (MZI) demonstrates the corresponding wavelength shift to various pH values in sweat. The fiber-optic sensor presents a high pH sensitivity of -27.06nm/pH in the physiological sweat pH value ranging from 5.0 to 7.5 with a low temperature cross-sensitivity of 0.012 nm/°C in the normal physiological range of 25-45°C. Further, the pH sensing range can be extended to pH 10 in aqueous solutions, and the sensitivity is 28.44nm/pH. Considering the advantages including wide sensing range, simple fabrication technique, and high sensitivity, the sensor can be potentially applied in many other liquid physiological detections for healthcare monitoring.

SLiCE: Implementation of automation technology and Internet of Things in the greenhouse

SMK Negeri 1 Sidoarjo aims to create an automated hydroponic greenhouse system with IoT technology. Limited knowledge and costs hinder their progress. However, the Audio Video Engineering Department seeks assistance to achieve the program's goals by upgrading their knowledge and skills in automation. The Service Learning in Computer Engineering (SLiCE) program focuses on introducing and implementing automation and IoT technology in greenhouses. The community service project starts with surveys and discussions involving the principal and teachers. It then proceeds to analyze the needs and develop a hydroponic and IoT automation system. Training is provided for students and teachers of SMK Negeri 1 Sidoarjo. The ESP32 microcontroller enables remote monitoring and automatic control of nutrient levels and water pH, ensuring optimal plant growth. The outcome is a real-time hydroponic automation system capable of monitoring pH, nutrient PPM, and controlling nutrient addition through a website. After training, 87.9% of students reported improved comprehension of IoT and its implementation.

Preparation of porous alginate-based smart dressings used in real-time monitoring of pH in chronic wounds by evaluating two fabrication routes: freeze-drying vs. electrospinning

Preparation of porous alginate-based smart dressings used in real-time monitoring of pH in chronic wounds by evaluating two fabrication routes: freeze-drying vs. electrospinning

Continuous pH monitoring using a sensor for the early detection of anastomotic leaks.

Anastomotic leaks (AL) and staple line leaks are a serious post-operative complication that can develop following bariatric surgery. The delay in the onset of symptoms following a leak usually results in reactive diagnostics and treatment, leading to increased patient morbidity and mortality, and a clinical and economic burden on both the patient and the hospital. Despite support in literature for pH as a biomarker for early detection of AL, the current methods of pH detection require significant clinician involvement and resources. Presented here is a polyaniline (PANI)-based pH sensor that can be connected inline to surgical drains to continuously monitor peritoneal secretion in real time for homeostatic changes in pH. During this study, the baseline peritoneal fluid pH was measured in two pigs using the PANI sensor and verified using a benchtop pH probe. The PANI sensor was then utilized to continuously monitor the changes in the pH of peritoneal effluent, as a gastric leak was simulated. The inline sensors were able to detect the resulting local changes in drainage pH within 10 min of leak induction. The successful implementation of this sensor in clinical practice can both enable high efficiency continuous monitoring of patient status and drastically decrease the time required to detect AL, thus potentially decreasing the clinical and economic burden incurred by gastric leaks.

N-Protonation as a Switch of the Twisted Excited States with ππ* or nπ* Character and Correlation with the π-Electrons Characteristic of Rotatable Bonds.

N-protonation for numerous fluorophores is widely known as an efficient switch for the fluorescence turn-on/off in acidic conditions, which has been applied in various scenarios that involve pH monitoring. Yet the universal mechanism for fluorescence regulation through N-protonation is still elusive. Herein, the excited state deactivation processes are systematically investigated for a series of nitrogen-containing fluorescent probes through theoretical approaches. Two types of mechanisms for the complex fluorescent phenomena by N-protonation are concluded: one is through the regulation for the transition to a ππ* twisted intramolecular charge transfer (TICT) state; the other one applies for the case when nonradiative decay pathway is predominant by a dark nπ* state, which is also accompanied by an evident structural twisting and can be regarded as another kind of TICT state. More generally, the formation of the TICT state is closely related to the conjugated π-electrons on the single bond that links the acceptor and donor part of fluorophores, which provides a simple strategy for evaluating the occurrence of the TICT process. The current contributions can bring novel insights for the rational design of functional fluorophores that involve TICT process in the excited states.

Architectures and Mechanisms of Perylene Diimide-Based Optical Chemosensors for pH Probing

The precise control and monitoring of pH values remain critical for many chemical, physiological and biological processes. Perylene diimide (PDI)-based molecules and materials exhibit excellent thermal, chemical and photochemical stability, unique UV-vis absorption and fluorescent emission properties, low cytotoxicity, as well as intrinsic electron-withdrawing (n-type semiconductor) nature and impressive molecular assembly capability. These features combined enable promising applications of PDIs in chemosensors via optical signal modulations (e.g., fluorescent or colorimetric). One of the typical applications lies in the probing of pH under various conditions, which in turn helps monitor the extracellular (environmental) and intracellular pH change and pH-relying molecular recognition of inorganic or organic ions, as well as biological species, and so on. In this review, we give a special overview of the recent progress in PDI-based optical chemosensors for pH probing in various aqueous and binary water–organic media. Specific emphasis will be given to the key design roles of sensing materials regarding the architectures and the corresponding sensing mechanisms for a sensitive and selective pH response. The molecular design of PDIs and structural optimization of their assemblies in order to be suitable for sensing various pH ranges as applied in diverse scenarios will be discussed in detail. Moreover, the future perspective will be discussed, focusing on the current key challenges of PDI-based chemosensors in pH monitoring and the potential approach of new research, which may help address the challenges.

A Systematic Design and Synthesis of PET-based Fluorescent Probes for Monitoring pH During Mitophagy.

Mitochondria are the powerhouse of the cell and function at pH ∼8.0. Dysfunctions of mitochondria, includes mitochondrial damage, leading to pH alteration. Hence, researchers aim to develop efficient pH probes for tracking mitochondrial pH dynamics. Herein, we developed a PET-based fluorescent probe for pH monitoring during mitochondrial dysfunctions. Three derivatives were synthesized with a variable spacer's length in pentacyclic pyridinium fluorophores (PM-C2, PM-C3, and PM-C6). An efficient electron transfers from the receptor (tertiary amine) was observed in the case of PM-C2 compared to the other two derivatives. This PET process was inhibited when tertiary amine was protonated in acidic pH. However, PM-C3 showed minimal fluorescence intensity at similar conditions and almost negligible change in case of PM-C6, suggesting poor PET process for both the derivatives. Furthermore, DFT/TD-DFT quantum chemical calculation well supported this optical phenomena and PET process. Biocompatible, photostable, and mitochondria-specific PM-C2 could monitor pH dynamics during mitochondrial damage which were engulfed by lysosome, also known as mitophagy. This mitophagy process were induced by rapamycin and starvation, which can be monitored by turn-on fluorescence enhancement. This process was further validated by tracking Parkin-protein translocation from cytoplasm to damaged mitochondria using our developed probe.

DNA tetrahedron–mediated triplex molecular switch for extracellular pH monitoring

This study aimed to construct a novel DNA triplex molecular switch modified with DNA tetrahedron (DTMS-DT) with sensitive response to extracellular pH using a DNA tetrahedron as the anchoring unit and DNA triplex as the response unit. The results showed that the DTMS-DT had desirable pH sensitivity, excellent reversibility, outstanding anti-interference ability, and good biocompatibility. Confocal laser scanning microscopy suggested that the DTMS-DT could not only be stably anchored on the cell membrane but also be employed to dynamically monitor the change in extracellular pH. Compared with the reported probes for extracellular pH monitoring, the designed DNA tetrahedron-mediated triplex molecular switch exhibited higher cell surface stability and brought the pH-responsive unit closer to the cell membrane surface, making the results more reliable. In general, developing the DNA tetrahedron-based DNA triplex molecular switch is helpful for understanding and illustrating the pH dependent cell behaviors and disease diagnostics.

Relevance of Barium Studies in an Era of Cross-Sectional Imaging in a Low Resource Economy

Purpose: The demand for barium tests has steadily decreased since the development of contemporary imaging technology, for a variety of reasons, in the current era of cancer. It is crucial to note right now that barium exams will never be unnecessary. Barium exams have largely been superseded by a number of advanced imaging modalities in recent years, including high resolution ultrasonography, endoscopy, colonoscopy, computed tomography (CT scan), magnetic resonance imaging (MRI), and defecography. Barium swallows still outperform endoscopy, manometry, and 24-hour esophageal pH monitoring in the assessment of motility issues, sub-mucosal lesions, and extrinsic pathology even though these diagnostic techniques are equally helpful in the evaluation of esophageal illnesses. The target is to maintain the traditional barium study method for the patient's benefit and proper care, as well as to keep it alive. The objective is to safeguard barium radiology for the high standard of patient care rather than to "save" barium exams only to maintain this technology. The main aim of this study is to review the various forms of barium studies&#x0D; Methodology: Relevant databases such as PubMed, Google Scholar and Embase to search for literature related to barium studies and cross sectional imaging were used for this study. Search strategy including keywords related to barium studies, cross-sectional imaging and low resource economies. This may include terms such as barium swallow, barium meal, computed tomography, magnetic resonance imaging.&#x0D; Findings: Conventional Barium examinations still have a purpose in determining the state of the mucosa, diameter of the lumen, degree, and type of obstruction even though CT and MRI have essentially superseded them. Additionally, barium offers live data on intestinal transit duration and motility. On a CT scan, these characteristics are not visible&#x0D; Recommendations: To prevent this modality from going extinct and ultimately harming patients, teaching institutions should encourage radiologists to become conversant with Barium studies.&#x0D; &#x0D; &#x0D; &#x0D;

Refractory Gastroesophageal Reflux Disease: Scopes Beyond PPI

Gastroesophageal reflux disease (GERD) is a very common GI disorder where the reflux of gastric contents into the esophagus causes symptom generation. PPI is the principal weapon to fight against GERD. An empiric course of PPI therapy is a cost-effective strategy for managing GERD. But sometimes, PPI can only do so much if taken correctly. As PPI does not reduce the number of reflux, other measures, including lifestyle modification, are required to get relief of GERD symptoms. Most patients respond to 8 weeks of PPI therapy, but 20-40% do not respond or respond partially. While these patients are labeled as having refractory heartburn, many do not have GERD or have not been treated adequately. So, alternative etiology must be considered when patients are refractory to PPI. Endoscopy of upper GIT should be done initially in case of the presence of alarm symptoms and when considered refractory to exclude other conditions. If endoscopy reveals no abnormality, then esophageal function tests like esophageal manometry, 24 hrs ambulatory pH monitoring, and mucosal impedance test can be considered to exclude other related conditions. Endoscopic and surgical treatment options can also be considered in particular cases. J Dhaka Med Coll. 2022; 31(1) : 148-157

Exploring objective factors to predict successful outcomes after laparoscopic Nissen fundoplication.

Currently, the reported parameters that predict the resolution of symptoms after surgery are largely subjective and unreliable. Considering that fundoplication rebuilds the structural integrity of the lower esophageal sphincter (LES), the authors focused on searching for objective and quantitative predictors for the resolution of symptoms based on the anatomical issues and whether an antireflux barrier can be well established or not. The authors reviewed the prospectively collected data of 266 patients with gastroesophageal reflux disease (GERD) who had undergone laparoscopic Nissen fundoplication (LNF). All patients were diagnosed with GERD using preoperative esophagogastroduodenoscopy, 24-h ambulatory esophageal pH monitoring, and high-resolution esophageal manometry. The patients received GERD symptom surveys using the validated Korean Antireflux Surgery Group questionnaire twice: preoperatively and 3 months after the surgery. After excluding patients with insufficient follow-up data, 152 patients were included in the analysis. Multivariate logistic regression analyses revealed that a longer length of the LES and lower BMI determined better resolution of typical symptoms after LNF (all P <0.05). Regarding atypical symptoms, higher resting pressure of LES and DeMeester score greater than or equal to 14.7 were associated with better resolution after the surgery (all P <0.05). After LNF, typical symptoms improved in 34 out of 37 patients (91.9%) with a length of LES >greater than .05cm, BMI less than 23.67kg/m 2 , and atypical symptoms were resolved in 16 out of 19 patients (84.2%) with resting pressure of LES greater than or equal to 19.65mmHg, DeMeester score greater than or equal to 14.7. These results show that the preoperative length and resting pressure of LES is important in the objective prediction of symptom improvement after LNF.

A wearable sensor based on multifunctional conductive hydrogel for simultaneous accurate pH and tyrosine monitoring in sweat

Flexible and wearable sweat sensors have drawn extensive attention by virtue of their continuous and real-time monitoring of molecular level information. However, current sweat-based sensors still pose several challenges, such as low accuracy for analytes detection, susceptibility to microorganism and poor mechanical performance. Herein, we demonstrated a noninvasive wearable sweat sensing patch composed of an electrochemical sensing system, and a pilocarpine-based iontophoretic system to stimulate sweat secretion. The electrochemical sensor based on tannic acid-Ag-carbon nanotube-polyaniline (TA-Ag-CNT-PANI) composite hydrogel was designed for on-body detection of pH and tyrosine (Tyr), a disease marker associated with multiple disorders, such as tyrosinemia and bulimia nervosa. The wearable sweat sensor can not only monitor the pH and Tyr in sweat simultaneously, but also further calibrate Tyr detection results with the measured pH value, so as to eliminate the effect of Tyr response variance at different pH and enhance the accuracy of the sensor. Furthermore, the presence of tannic acid chelated-Ag nanoparticles (TA-Ag NPs) and carbon nanotubes (CNTs) significantly improved the conductivity and flexibility of the hydrogel and endowed the composite hydrogel with antibacterial capability. Of note, the constructed wearable sensor was capable of monitoring Tyr with enhanced accuracy in various sweats.

Patient adverse events and technical failures with the bravo capsule pH system: insights from the MAUDE database.

The BRAVO pH monitor system can benefit patients with ongoing GERD symptoms despite treatment and/or atypical symptoms. We aim to investigate the number and type of complications associated with the BRAVO pH capsule. From April 2016 through February 2021, we analyzed post-marketing surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database. During the study period, approximately 1,651 reports were identified with 2391 cases associated with a device failure, and 254 reporting a patient-related adverse event. Most device complications were due to aspiration n = 153), followed by reported pain (n = 79), injury (unspecified) (n = 63), and additional radiologic imaging (n = 44). Laceration and bleeding accounted for 29 and 19 cases. Furthermore, three patients suffered perforation. Most device failures were due to loss or failure of the Bravo capsule to bond or adhere to the esophageal mucosa as planned (n = 1269), followed by an activation or positioning failure (n = 972), premature detachment of device (n = 284), and failure of the device to record or transmit data (n = 158). Findings from the MAUDE database highlight the risk of aspiration, hemorrhage/bleeding, perforation, injury, and retention as potential complications of BRAVO capsule placement.

Entering into 2.0 cystinuric management with a medical digital tool to monitor urine pH: a prospective, randomized study

Background and objectivesIndividuals with cystinuria can experiment recurrent lithiasis events due to the relative insolubility of cystine at physiological urine pH, resulting in renal function decline. The Lit-Control® pH Meter is a medical device that accurately allows urine pH self-monitoring. The main objective of this study was to compare the usability of the Lit-Control® pH Meter with the reactive strips for self-monitoring of urinary pH at home by patients with cystinuria, and their overall satisfaction with each tool. Patients and methodsWe included 28 patients (9 females and 19 males, age 19–76 years), who were randomly assigned to monitor their urine pH with reactive strips (n = 17) or the Lit-Control® pH-meter (n = 11). ResultsAfter six months of use, the satisfaction with the two methods was similarly high, but the patients rated (0–10 scale) the pH meter better in terms of ease of learning (mean ± SD, 8.11 ± 0.60 vs. 7.06 ± 1.18; P = 0.038), ease to prepare (8.22 ± 0.67 vs. 7.25 ± 1.18; P = 0.034), and ease of use (8.22 ± 0.67 vs. 7.25 ± 1.39; P = 0.062). Overall, patients did not reach the alkalinization goals (pH between 7.0 and 8.0). ConclusionsThe Lit-Control® pH Meter demonstrated to be an easy-to-use device that can facilitate urinary pH control by cystinuric patients. A prospective study is warranted to assess the correlation between urine pH monitoring, a treat to target approach, and the recurrence of cystine stones.

False-positive symptoms of recurrence of gastroesophageal reflux disease (gerd) in patients with hiatal hernia (hh) after anti-reflux videolaparoscopy

We compared the results of remote survey of 213 patients with HH associated with GERD in the long term after anti-reflux videolaparoscopy, according to the GERD-HRQL, GIQLI, and SF-36 questionnaires (patients’ complaints) and special methods for studying the anti-reflux function of the cardia (X-ray endoscopy of the esophagus and stomach, daily esophageal pH monitoring, esophageal manometry). Based on the results of special studies, a generalized indicator of failure of the anti-reflux function of the cardia (GIFAFC) was developed. It was found that 57.3% of the examined patients had false-positive symptoms of GERD recurrence, which was manifested by pain in the epigastric region (31.2%), belching with air (4.1%), and heartburn (21.3%). There were no symptoms when bent over or lying down. The existing symptoms were mild, easily stopped by conservative treatment. The patients with false-positive GERD symptoms after surgery showed an improvement in GIFAFC by 7.9 times (p &lt;0.001), but it was 5.4 times worse than in patients without recurrent GERD (p &lt;0.001), and 6.3 times better in relation to patients with recurrent GERD (p&lt;0.05). False-positive symptoms of GERD recurrence contributed to a decrease in the generalized indicator of quality of life, which, according to the SF-36 questionnaire, was 76% of the maximum desired result. Due to the absence of reliable clinical manifestations, all patients with HH who have certain symptoms of GERD after fundoplication should undergo an instrumental study of the anti-reflux function of the cardia. Patients with established false-positive symptoms of GERD are subject to dispensary follow-up.