Mo1117 Patients With Non-Acid Reflux Disease and Those With Erosive and Non-Erosive Reflux Disease Have Similar Response to Anti-Reflux Surgical Therapy

Abstract

Background: In the last decade combined impedance-pH monitoring has become the gold standard for the detection of reflux episodes with several studies demonstrating its increased diagnostic yield in gastro-esophageal reflux disease (GERD). This is mainly due to the capability of impedance-pH to correlate symptoms to both acid and non-acid reflux episodes. However, despite its large use in clinical practice, limited data about its clinical usefulness for the management of GERD patients are present. AimM mean age 49; 14 ERD, 22 NERD and 12 NARD) reporting at least 3 symptoms during the impedance-pH monitoring were included. Fundoplication had a similar effect in all groups, as shown in the Figure. At 1 year, esophageal AET and number of total, acid and non-acid refluxes significantly decreased after surgery (in all cases, p<0.01), whereas mean lower esophageal pressure increased (p<0.05). The percentage of patients with resolved or markedly improved typical symptoms at 12 months after surgery was similar among the groups (ERD 93% vs. NERD 82% vs NARD 83%, p=ns). Quality of life similarly improved in all groups (p=ns). Finally, the percentage of failure or adverse events did not differ among the groups (ERD 21% vs. NERD 23% vs NARD 17%, p=ns). Conclusion: Our data show that laparoscopic fundoplication was a safe and effective procedure in relieving typical reflux symptoms in patients with NARD as well as in patients with ERD and NERD, thus markedly improving their quality of life. Therefore, impedance-pH monitoring facilitated a more focused therapeutical approach to patients with PPI-resistant GERD.