Abstracts
1999 Digestive Disease Week

# 2107 IRRITABLE BOWEL SYMPTOMS PREDICT WORSE FUNCTIONAL OUTCOME AFTER LAPAROSCOPIC ANTIREFLUX SURGERY
Karen R Draper, C Lind, Howard Mertz, M Caudill, K Sharp, M Holzman, R Wolff, W O Richards, Vanderbilt Univ Med Ctr, Nashville, TN

Introduction: We have previously identified, in a group of 16 patients, that non-esophageal symptoms predict a worse outcome after laparoscopic antireflux surgery (Gastro 1998; 114:A204). This follow up study of a larger cohort of 40 patients was designed to evaluate functional results after antireflux surgery and identify predictors of functional outcome.
Methods: Patients referred for anti-reflux surgery completed a self-administered G.I. symptom survey. The survey has 19 questions to evaluate 4 G.I. symptom complexes: 1) GE reflux, 2) abdominal discomfort, 3) irritable bowel symptoms, and 4) dysphagia. Each question is scored on a Likert scale with 0=no symptoms and 100=constant, severe symptoms. All patients who completed the GI symptom survey before and after antireflux surgery were included in the study.
Results: 40 patients were studied. Comparisons of pre- and postop symptoms scores using paired Student's T-test are as follows: Comparison of postop GE reflux scores in patients with preoperative irritable bowel scores below and above 33, is as follows:
Conclusions: Symptoms of GE reflux, abdominal pain, and dysphagia markedly improve after laparoscopic antireflux surgery. Irritable bowel symptoms do not improve after antireflux surgery. Patients with high preoperative IBS scores have significantly worse GE reflux scores before and after antireflux surgery, which may reflect a higher sensitization of the GI tract in these patients. Preoperative assessment of irritable bowel symptoms may be useful to optimize patient selection for surgical antireflux therapy.

Symptom group	*Preop scores	*Postop scores	p-value
GE Reflux	54.3±3.3	20.8±4.1	<0.001
Abd discomfort	40.7±3.9	21.5±4.1	0.001
Dysphagia	43.8±5.9	20.0±4.2	0.002
Irritable bowel	19.1±2.3	19.0±3.0	0.97
* (Values expressed as mean ± SEM)

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