title: Reflux symptoms and side effects among patients with gastroesophageal reflux disease at baseline, during treatment with PPIs, and after Nissen fundoplication.
abstract: BACKGROUND
  There are no prospective studies available on the behavior of extraesophageal and esophageal symptoms and treatment-related side effects in patients without effective antireflux medication, receiving the most effective antireflux medication, and after laparoscopic fundoplication.
  
  
  METHODS
  Extraesophageal and esophageal reflux symptoms and treatment-related side effects were assessed in 60 patients while they were on no effective antireflux medication (three-week washout period), after three month of treatment with double-dose esomeprazole, and 3 months after laparoscopic Nissen fundoplication. Esophageal and extraesophageal reflux symptoms, rectal flatulence, and bloating were analyzed with the visual analog scale. In addition, dysphagia, rectal flatulence, and bloating were recorded as none, mild, moderate, or severe.
  
  
  RESULTS
  Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were further reduced after fundoplication. Dysphagia and flatulence did not increase from baseline after surgery. Bloating decreased both after treatment with esomeprazole and after fundoplication. In contrast, dysphagia and increased flatus were found more often after surgery than during treatment with esomeprazole. Dysphagia and rectal flatulence were less common during treatment with esomeprazole than at baseline or after surgery.
  
  
  CONCLUSIONS
  Both extraesophageal and esophageal reflux symptoms decreased after treatment with esomeprazole and were reduced further after fundoplication. Any treatment-related side effect was not increased after surgery when compared to baseline. However, compared to esomeprazole there was more dysphagia and flatulence after fundoplication.
authors: Department of Surgery, Central Hospital of Seinäjoki, Hanneksenrinne 7, 60220, Seinäjoki, Finland. tuomo.rantanen@uta.fi
authors: Tuomo
authors: T
authors: Rantanen
authors: Toni
authors: T
authors: Kiljander
authors: Paulina
authors: P
authors: Salminen
authors: Arto
authors: A
authors: Ranta
authors: Niku
authors: N
authors: Oksala
authors: Ilmo
authors: I
authors: Kellokumpu
mesh_terms: D064098:Esomeprazole / Q000627:therapeutic use; D005260:Female; D005387:Finland; D005414:Flatulence / Q000209:etiology; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors; D064098:Esomeprazole