Do patients with gastroesophageal reflux disease and somatoform tendencies benefit from antireflux surgery?

Figure 1 Incidence of somatoform symptoms in patients with gastroesophageal reflux disease. Group A: patients with indication for surgery, willing to undergo surgery. The percentage of SSI ≥ 17 was 22%; Group B: Patients with GERD and indication for surgery, who has refused antireflux surgery and have continued protonpump inhibitors therapy. The percentage of SSI ≥ 17 was 20%. GERD: Gastroesophageal reflux disease; SSI: Somatoform Symptom Index.

Figure 2 Preoperative quality of life, as measured by the Gastrointestinal Quality of Life Index in patients with gastroesophageal reflux disease alone (median GIQLI: 105) and patients with gastroesophageal reflux disease and associated somatoform tendencies (SSI ≥ 17) (median GIQLI: 77). This difference is significant (P < 0.001). SSI: Somatoform Symptom Index; GIQLI: Gastrointestinal Quality of Life Index; GERD: Gastroesophageal reflux disease.

Figure 3 Pre-and post-therapeutic quality of life, as measured by the Gastrointestinal Quality of Life Index, for both groups. Group A after laparoscopic antireflux surgery (GIQLI preop: 91; postop 117; P < 0,001) and Group B after continued conservative treatment (GIQLI pre: 96; post: 98; P = 0.8279). In the surgical group, GIQLI could be significantly increased. GIQLI: Gastrointestinal Quality of Life Index.

Figure 4 Comparison of pre- and postoperative levels of Gastrointestinal Quality of Life Index in relation to the presence of somatoform disorders. Patients with somatoform disorders will also improve their GIQLI postoperatively (GIQLI preop: 75; postop: 95; P < 0.0043), however it could not be increased to normal levels due to the large number of non-related symptoms. Patients with SSI < 17 could reach normal levels of GIQLI postoperatively (preop: 102; postop: 117; P < 0.001). GIQLI: Gastrointestinal Quality of Life Index; SSI: Somatoform Symptom Index; GERD: Gastroesophageal reflux disease.