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Long-term follow up in patients with GERD

A study in this month's issue of the Scandanavian Journal of Gastroenterology evaluated long-term results of GERD treatments with regard to reflux symptoms, use of anti-reflux medication and anti-reflux surgery outcome.

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Various treatment modalities are currently being used in patients with gastroesophageal reflux disease (GERD).

However, long-term outcome is not clear.

Dr Suzanne Van Meer and colleagues from the Netherlands evaluated long-term results of GERD treatments with regard to reflux symptoms, use of anti-reflux medication and anti-reflux surgery outcome.

Patients who had undergone 24-h pH monitoring for reflux symptoms between 2002 and 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.

The daily PPI use was higher in the conservative group
Scandanavian Journal of Gastroenterology

In total, 1027 of 2190 included patients returned the questionnaires.

The researchers analyzed 477 patients after exclusion due to predefined criteria.

Median total RDQ score was 18 points in the conservative group, and 10 points in the surgical group after a mean follow up of 5 years.

The daily proton pomp inhibitor (PPI) use was higher in the conservative group than in the surgical group.

The research team showed an association between RDQ scores and anti-reflux surgery, and male gender.

The researchers also observed that daily PPI use was lower in patients who underwent anti-reflux surgery, while it increased with age.

Dr Van Meer's team concludes, "There is still a high prevalence of typical reflux symptoms and daily PPI use in GERD patients after more than 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."

Scand J Gastroenterol 2013: 48(11): 1242-1248
12 November 2013

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