Abstracts
1999 Digestive Disease Week

# 2108 QUALITY OF LIFE IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE
Karl Hermann Fuchs, Martin Fein, Stefan M Freys, Johannes Heimbucher, Joern Maroske, Harald Tigges, Arnulf Thiede, Univ of Wuerzburg, Wuerzburg Germany

Indications for surgery in gastroesophageal reflux disease (GERD) are not only established in the presence of complications, but also in patients with reduced quality of life (QL). However, there is little data available on QL in these patients. The aim of this study was to assess QL in patients with GERD under medical therapy and after antireflux surgery. In our surgical unit 148 patients with documented GERD (51±13y; 78m,70f) were prospectively evaluated using the Gastrointestinal Quality of Life Index (GIQLI). Of these, 50 underwent laparoscopic antireflux surgery and were assessed one year postoperatively (p/o). The GIQLI scores were compared with age-matched healthy controls (n=150, score: 121±15). Patients were classified by the following criteria: on proton pump inhibitors (PPI), not on PPI; duration of disease: £ 1 year, > 1 year; 1 year p/o. Overall, QL was significantly impaired in non operated patients with reflux disease (score: 93±22, p < 0.0001 compared to controls). Patients on PPI (n=95, score: 90±22) had a significant lower GIQLI score than patients not on PPI (n=53, score: 98±21). This is caused by a significant difference in the perception of GI symptoms. Patients with disease £ 1 year tended to have a less impaired QL (n=25, score: 97±27) compared to patients > 1 year (n=121, score: 91±21). In the first year of disease PPI were able to control symptoms best as shown by an identical QL in this group (pts on PPI: 99±29, pts not on PPI: 97±26). Of note, one year after antireflux surgery the GIQLI score was 113±22 (p < 0.0001 versus 90±20 preop). In conclusion, quality of life is extremely compromised in patients with GERD. Use of PPI can improve QL in the first year of disease. Longer duration of disease results in further loss of QL despite PPI treatment. Antireflux surgery can improve QL even after a long duration of disease.

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