Analysis of illness behavior in patients after "failed" antireflux surgery.
OBJECTIVE
Patients complaining of problems after antireflux surgery may have differences in illness behavior that could influence the decision to perform a revision procedure or its outcome.


METHODS
A prospective comparative questionnaire survey of consecutive series of patients.


METHODS
University teaching hospital.


METHODS
Those undergoing esophageal pH and manometric studies from July 1, 2001, through July 1, 2004, for investigation of new or recurrent symptoms after previous antireflux surgery. There were 52 eligible patients, of whom 4 were excluded because of refusal to enter the study (n = 1) or communication difficulties (n = 3). Of the remaining 48 patients, 22 underwent revision surgery and 26 did not. These 2 groups were compared with 167 patients with primary gastroesophageal reflux disease investigated during the same period.


METHODS
Self-administered, validated illness behavior questionnaire completed after informed consent was obtained.


METHODS
Illness behavior categories derived from the questionnaire answers: general hypochondriasis, disease conviction, psychological vs somatic illness perception, affective inhibition, affective disturbance, denial, irritability, Whiteley index of hypochondriasis, affective state, and disease affirmation.


RESULTS
There were no significant differences in illness behavior category scores between the 2 groups with postoperative problems and patients with primary gastroesophageal reflux disease.


CONCLUSIONS
Patients with problems after antireflux surgery have an illness behavior profile similar to that in patients with primary gastroesophageal reflux disease irrespective of whether there is objective evidence of recurrent reflux disease.
University of Adelaide Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Jeremy D
JD
Hayden
Jennifer C
JC
Myers
Glyn G
GG
Jamieson
D000328:Adult; D000368:Aged; D005764:Gastroesophageal Reflux / Q000523:psychology / Q000601:surgery*; D006801:Humans; D006998:Hypochondriasis; D008875:Middle Aged; D019964:Mood Disorders; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D017211:Treatment Failure