Do patients with gastroesophageal reflux disease and somatoform tendencies benefit from antireflux surgery?

  • Background: The clinical presentation of gastroesophageal reflux disease (GERD) shows a large symptom variation also in different intensities among patients. As several studies have shown, there is a large overlap in the symptomatic spectrum between proven GERD and other disorders such as dyspepsia, functional heartburn and/or somatoform disorders. Aim: To prospectively evaluate the GERD patients with and without somatoform disorders before and after laparoscopic antireflux surgery. Methods: In a tertiary referral center for foregut surgery over a period of 3 years patients with GERD, qualifying for the indication of laparoscopic antireflux surgery, were investigated prospectively regarding their symptomatic spectrum in order to identify GERD and associated somatoform disorders. Assessment of symptoms was performed by an instrument for the evaluation of somatoform disorders [Somatoform Symptom Index (SSI) > 17]. Quality of life was evaluated by Gastrointestinal Quality of Life Index (GIQLI). Results: In 123 patients an indication for laparoscopic antireflux surgery was established and in 43 patients further medical therapy was suggested. The portion of somatoform tendencies in the total patient population was 20.48% (34 patients). Patients with a positive SSI had a preoperative GIQLI of 77 (32-111). Patients with a normal SSI had a GIQLI of 105 (29-140) (P < 0.0001). In patients with GERD the quality of life could be normalized from preoperative reduced values of GIQLI 102 (47-140) to postoperative values of 117 (44-144). In patients with GERD and somatoform disorders, the GIQLI was improved from preoperative GIQLI 75 (47-111) to postoperative 95 (44-122) (P < 0.0043). Conclusion: Patients with GERD and associated somatoform disorders have significantly worse levels of quality of life. The latter patients can also benefit from laparoscopic fundoplication, however they will not reach a normal level.

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Author:Hans Friedrich Fuchs, Benjamin Babic, Karl-Hermann Fuchs, Wolfram Breithaupt, Gabor Varga, Frauke Musial
URN:urn:nbn:de:hebis:30:3-484786
DOI:https://doi.org/10.3748/wjg.v25.i3.388
ISSN:2219-2840
ISSN:1007-9327
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/30686906
Parent Title (English):World journal of gastroenterology
Publisher:WJG Press
Place of publication:Beijing
Contributor(s):Yan Huang, Ze-Mao Gong
Document Type:Article
Language:English
Year of Completion:2019
Date of first Publication:2019/01/21
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/03/12
Tag:Antireflux surgery; Gastroesophageal reflux disease; Gastroesophageal reflux disease symptoms; Laparoscopic fundoplication; Somatization
Volume:25
Issue:3
Page Number:15
First Page:388
Last Page:397
Note:
Copyright © The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
HeBIS-PPN:448058421
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 4.0