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    Heartburn Surgery Gives Relief, Not Cure

    Symptoms, Sleep, Eating Improved, but Drugs Still Necessary
    WebMD Feature

    April 15, 2002 -- Surgery to relieve heartburn seems to have many satisfied customers. A study finds that up to five years after surgery, many patients still have symptoms -- yet nearly all felt their surgery was working well.

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    Your doctor may be able to diagnose gastroesophageal reflux disease, or GERD, from your description of symptoms. The doctor may also suggest tests to rule out other possible causes of your symptoms, to monitor the degree of damage, or to determine the best treatment for you. The three main tests used when GERD is suspected or known are esophageal pH monitoring, endoscopy, and manometry. With pH monitoring, the doctor measures the amount of acid in the esophagus over a 24-48 hour period. This test...

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    Daily heartburn is medically known as gastroesophageal reflux disease, or GERD, and though excess acid can be tamed through lifelong medication, many people opt for surgery. The surgery corrects the underlying defect in the valve that normally keeps acid from flowing from the stomach back up into the esophagus. However, recent studies have cast doubt on the surgery's long-term effectiveness, since many patients still required medications to control their acid reflux.

    The current study finds that although they still have symptoms -- and take action to control them -- "most believe their surgical treatment is working well," writes lead author Jean Y. Liu, MD, MS, researcher at Dartmouth-Hitchcock Medical Center in Lebanon, N.H.

    The study appears in the April issue of Archives of Surgery.

    In the study, Liu analyzed 247 patients, 197 of whom had the laparoscopic procedure -- the less invasive type in which several small holes are made in the abdomen instead of one large cut. After their surgery, 28% were bothered by typical reflux symptoms of heartburn, but only 5% were bothered "a lot" or "terribly" by it; 65% reported bloating, but only 19% were bothered a lot or terribly.

    In fact, 80% said they were "delighted or pleased" with their current symptoms; 6% were neutral; and 14% felt unhappy or terrible. Overall, 90% believed their surgery was working well, and 50% reported that it was working "perfectly." When asked about their eating and sleeping habits, 86% reported they were able to "eat what they want, when they want" and 81% reported that their "sleeping habits were back to normal."

    The researchers write that patients undergoing laparoscopic surgery for acid reflux should not expect surgery to cure their problem. Many will continue to experience some symptoms or need to take some action to control these symptoms. Most patients, however, will experience significant improvement in their heartburn symptoms.

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