Surgery has been reported to be effective in gastroesophageal reflux disease (GERD) patients when medical management fails. However, there seems to be no consensus on the indication for a surgical evaluation.

Rasmussen et al assessed if the GERD-HRQL questionnaire scores correlate with objective findings in patients undergoing anti-reflux surgery to predict when surgical evaluation is needed.

A prospective database was used for patients undergoing anti-reflux surgery between January 2014 and September 2020. Inclusion criteria were a diagnosis of GERD and comprehensive esophageal workup with the GERD-HRQL questionnaire, EGD, esophageal manometry, and ambulatory pH monitoring. Analysis of the GERD-HRQL scores was compared with objective endpoints to determine the correlation and predictability. Logistic regression analysis helped evaluate the relationship between the presence of objective findings and GERD-HRQL questionnaire scores. A total of 246 patients met the inclusion criteria.

• There appeared to be no significant correlation between GERD-HRQL score and DeMeester score (correlation coefficient = 0.23), or presence of hiatal hernia, irrespective of the size (p = 0.89).
• The average GERD-HRQL scores were significantly higher in patients with esophagitis (40.1 ± 18.9), compared with those without esophagitis (30.4 ± 19.1; p < 0.0001).
• Patients having a score of >40 had a 42% to 65% likelihood of having esophagitis compared to a score of <30, reducing the chances of having esophagitis to less than 35%.

Use of a GERD-HRQL questionnaire score can demonstrate the correlation between subjective and objective findings in the workup of a patient for anti-reflux surgery.

Patients with a GERD-HRQL score of >40 have higher odds of esophagitis compared to those with a score of <30.

These scores can help clinicians identify the patients failing medical therapy and help with quick referral for surgical evaluation.

Source: Rasmussen M, Leeds SG, Ward MA, et al. Can subjective symptoms predict objective findings in gastroesophageal reflux disease patients? Surg Endosc. 2022 Feb 15.