Long-term follow up in patients with gastroesophageal reflux disease with specific emphasis on reflux symptoms, use of anti-reflux medication and anti-reflux surgery outcome: a retrospective study. (November 2013)

• Record Type: Journal Article
• Authors: Van Meer, Suzanne; Bogte, Auke; Siersema, Peter D
• Is Part Of: Scandinavian journal of gastroenterology. Volume 48:Number 11(2013)
• Page Start: 1242
• Page End: 1248
• Publication Date: 2013-11
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2013.834378
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Background.</italic> </bold> Various treatment modalities are currently being used in patients with gastroesophageal reflux disease (GERD); however, long-term outcome is not clear. The aim is to evaluate long-term results of GERD treatments with regard to reflux symptoms, use of anti-reflux medication and anti-reflux surgery outcome. <bold><italic>Methods.</italic></bold> Patients who had undergone 24-h pH monitoring for reflux symptoms between January 2002 and March 2012 were invited to fill out the Reflux Disease Questionnaire (RDQ) and a general questionnaire. Patients with and without anti-reflux surgery were compared using multiple linear and logistic regression models. <bold><italic>Results.</italic></bold> In total, 1027 of 2190 included patients (47%) returned the questionnaires. After exclusion due to predefined criteria, 477 patients were analyzed. Median total RDQ score was 18 points (10.2% symptom-free) in the conservative group (<italic>n</italic> = 304) and 10 points (31.2% symptom-free) in the surgical group (<italic>n</italic> = 173) after a mean follow up of 5.1 years. Daily proton pomp inhibitor (PPI) use was higher in the conservative group than in the surgical group (80.9% vs. 51.4%, <italic>p</italic> = 0.000). Linear regression analysis showed an association between RDQ scores and anti-reflux surgery (β = −5.477, <italic>p</italic> = 0.001) and male gender (β = −4.306, <italic>p</italic> = 0.006). Logistic regression analyses showed that daily PPI use was lower in patients who underwent anti-reflux surgery (odds ratio [OR] = 0.24, <italic>p</italic> = 0.000), while it increased with age (OR = 1.03, <italic>p</italic> = 0.000). <bold><italic>Conclusions.</italic></bold> There is still a high prevalence of typical reflux symptoms and daily PPI use in GERD patients after >5 years of follow up. Male patients and patients who had undergone anti-reflux surgery were more often asymptomatic. Daily PPI use was lower after anti-reflux surgery, while it increased with age.</p> </abstract>