Work

Does Patient Sex Influence the Symptom Pattern for Patients With Gastro‐Oesophageal Reflux Disease and the Response of Symptoms to Fundoplication?

Year: 2025

Type: article

Abstract: BACKGROUND: Several studies show that female patients experience lower satisfaction after anti-reflux surgery. We hypothesised that there is a pattern of symptoms common to female patients presenting with GORD and that it is these symptoms in particular that lead to inferior outcomes. We also hypothesised that these symptoms would respond differently to the different types of fundoplication. METHODS: Pre-operative and post-operative questionnaires for all patients undergoing laparoscopic fundoplication were analysed. Pre-operative symptoms, improvement of symptoms, patient demographics and type of fundoplication were assessed. RESULTS: The study evaluated 328 patients, 156 females and 172 males. Eighty-seven females (55.8%) and 135 males (78.5%) underwent a Nissen Fundoplication (p < 0.001) with the rest undergoing a posterior 270° (partial) fundoplication. Females reported most symptoms more frequently than males, and a predominantly female pattern of symptoms was identified. Bloating (p ≤ 0.001), asthma (p = 0.045), constipation (p = 0.010) and diarrhoea (p = 0.023) were significantly more associated with being female. At 18 months post-surgery, outcomes for patients presenting with 'female-pattern' symptoms were not improved by undertaking partial fundoplication when compared to Nissen fundoplication. The only symptom that was affected by the type of fundoplication was dysphagia, with a significant number of patients experiencing worsening of dysphagia after a Nissen fundoplication (p < 0.01). CONCLUSION: There are certain symptoms that affect female patients who present with GORD more commonly than male patients, and this may contribute to lower satisfaction outcomes. Partial fundoplication does not appear to offer a significant advantage in improving these symptoms.

Source: ANZ Journal of Surgery

DOI: 10.1111/ans.70152

Authors: Joshua N. Hammerschlag, Ross H. Roberts, Andrew McCombie

Institutions: Christchurch Hospital, Health New Zealand

Language: English

Topic: Gastroesophageal reflux and treatments

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,920