Laparoscopic antireflux surgery in patients with extra esophageal symptoms related to asthma

Abstract

BackgroundAsthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease.AimTo analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma.MethodsWere reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings.ResultsThe comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002).ConclusionLaparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma.

Review article: gastro‐oesophageal reflux disease in asthma and chronic obstructive pulmonary disease

“…As expected, 6 months after surgery there was a significant reduction of heartburn. More importantly, there was a significant difference in daily crises of asthma (Table ).…”

Evaluation of the Outcomes of Anti-Reflux Surgery in the Management of Extraoesophageal Symptoms of Gastro-oesophageal Reflux Disease

“…In a Large series of Silva et al (11) , which included 400 patients with three-year follow, they concluded that antireflux surgery was effective to relieve and control the GORD symptoms with no statistically significant difference between 6 months and 3 years after the surgery.…”

“…Numerous laryngeal symptoms, including hoarseness, sore throat, painful swallowing, lump in the throat, cough, repeated cleaning of the throat, abundant phlegm, trouble swallowing, and voice fatigue, can be brought on by GORD (7) Anti-reflux surgery has been shown to significantly improve respiratory symptoms associated with GORD and reduce the need for medications (11) .…”

“…Currently, empirical double dose of proton pump inhibitors (PPI), modifying one's diet and way of life are the standard treatment strategy used for management of GORD related EOS, although the efficacy of PPI to control these symptoms was still controversial. It has been demonstrated that anti-reflux surgery considerably reduces the requirement for medication and improves respiratory symptoms related to GORD (11) .…”

Late Evaluation of Patients Operated for Gastroesophageal Reflux Disease by Nissen Fundoplication

“…It is estimated that 12% of the Brazilian population has GERD. Anamnesis is fundamental for the diagnosis of this condition and special attention should be paid not only to typical symptoms (heartburn and acid regurgitation), but also to atypical symptoms (oral, otorhinolaryngological, and pulmonary) 13 , 29 .…”