MedWire News: Patients with gastroesophageal reflux disease response well to laparoscopic Nissen fundoplication reflux surgery to treat the condition, irrespective of what type of gastroesophageal reflux disease they have, researchers report.

Patients with gastroesophageal reflux commonly have symptoms that are related to body position. Patients who experience reflux when upright are believed to have worse outcomes following surgery than those who experience reflux when lying on their back or when in either position.

"As a result, some physicians have been reluctant to recommend antireflux surgery to patients with upright reflux," say Dr Marcus Patti, from the University of California-San Francisco, USA, and colleagues.

Dr Patti and team divided 225 patients with confirmed gastroesophageal reflux into three groups based on the type of disease, ie, upright reflux, supine (lying down) reflux, and bipositional reflux (both types). All patients were questioned before and after surgery about their symptoms, including heartburn, regurgitation, difficulty/pain with swallowing, cough and chest pain, and how long they lasted. Symptoms were then scored based on severity.

The research team found no difference in outcomes after surgery in patients with upright reflux compared to those with supine or bipositional reflux. There was also no difference in severity of symptoms among the three groups.

"Despite the effectiveness of surgery in controlling reflux, there are still some patients who continue to experience unwanted symptoms after the procedure, such as bloating, belching, fullness and early appetite satisfaction while eating," say the researchers in the journal Diseases of the Esophagus.

They conclude that, contrary to previous findings, laparoscopic surgery is effective in patients with all types of reflux. Other criteria should be used to predict post-surgical response, they say.