The efficacy of surgical treatment of gastroesophageal reflux disease complicated by respiratory symptoms

• Published in: Zeitschrift für Gastroenterologie
• Main Authors: Bálint, A, Máté, M, Dubecz, A, Solymosi, A, Regöly-Mérei, J
• Format: Conference Proceeding
• Language: German
• Published: 19.05.2004
• ISSN: 0044-2771; 1439-7803
• DOI: 10.1055/s-2004-827109

Introduction: Gastroesophageal reflux disease is frequently complicated by the development of respiratory/pharyngeal symptoms. By means of dual pH monitoring in the distal and proximal esophagus the severity of acid reflux activity can be detected. Based on the good clinical results obtained in patients who had undergone antireflux surgery for the treatment of erosive GERD with typical symptoms, we started to perform antireflux surgery in GERD patients with predominant respiratory symptoms. Aims and methods: in 26 patients where GERD was proved by dual pH monitoring and manometric study of the esophagus but the clinical picture was dominated by respiratory/pharyngeal symptoms were treated by laparoscopic Nissen fundoplication between January 1, 2000 and November 30, 2003. Results: Increased esophageal acid exposure in the distal and proximal esophagus was found in more than 2/3 of the patients with reflux and respiratory/pharyngeal symptoms. Subsequent to the surgical intervention a rapid improvement of typical symptoms could be observed, however, the amelioration of the atypical symptoms (cough, hoarseness) was delayed and less prominent as revealed by symptom score. The follow up pH monitoring studies performed on a small proportion of patients proved the efficacy of surgery. Conclusion: In our study group reflux patients with respiratory and pharyngeal symptoms had extensive distal and proximal esophageal acid exposure. The typical symptoms responded remarkably to antireflux surgery while atypical symptoms showed less prominent response. The efficacy of antireflux surgery on respiratory symptoms needs further investigations and follow up. The study was partly supported by Hungarian Scientific Research Fund T38244.