Response of atypical symptoms of GERD to antireflux surgery.

Hepato-gastroenterology

PubMedID: 19579608

Hamdy E, El-Shahawy M, Abd El-Shoubary M, Abd El-Raouf A, El-Hemaly M, Salah T, El-Hanafy E, GadEl Hak N. Response of atypical symptoms of GERD to antireflux surgery. Hepatogastroenterology. 2009;56(90):403-6.
BACKGROUND/AIMS
The results of laparoscopic Nissen's fundoplication (LNF) were compared in patients having typical and atypical symptoms of Gastroesophageal reflux disease (GERD). Atypical symptoms include asthma, chronic cough, non-cardiac chest pain, and ear, nose, and throat symptoms. The effectiveness of antireflux surgery in relief of these symptoms is uncertain.

METHODOLOGY
100 patients with GERD underwent laparoscopic Nissen's fundoplication in El-Mansoura Gastro-enterology center between January, 2002 and March, 2004. Patients were classified according to preoperative symptoms into 3 groups; group 1 (71 cases with severe typical and minimal atypical symptoms), group 2 (18 cases with severe typical and severe atypical symptoms) and group 3 (11 cases with minimal typical and severe atypical symptoms). Patients were reassessed within a mean period of 24 +/- 12 months after surgery.

RESULTS
Duration of illness was nearly similar in the three groups (3.2 +/- 2.7:3.3 +/- 2.9:3.7 +/- 3.2 years). In group 1, typical symptoms improved in 66 (92.9%) cases and resolved in 63 (88.7%). In group 2, typical symptoms improved in 17 (94.4%) and resolved in 16 (88.9%), whereas atypical symptoms improved in 15 (83.3%) and resolved in 10 (55.6%). In group 3, atypical symptoms improved in 9 (81.8%) and resolved in 5 (45.5%). Endoscopic, radiologic, esophageal motility and pH metry studies were nearly similar in the 3 groups.

CONCLUSIONS
Antireflux surgery improves atypical symptoms of GERD, but symptom resolution occurs in less than half of cases.