6% patients showed a normotensive lower esophageal sphincter compared to all patients showing hypotensive sphincter before surgery and this change was statistically significant. There was a statistically significant increase in the distance of lower esophageal sphincter from central incisors after surgery. Lower esophageal sphincter selleck relaxation remained complete both pre- and postoperatively in 100% cases. Hiatal hernia which was present in all cases (100%) pre-operatively was totally absent postoperatively (100%) and this difference was statistically significant. These findings were in accordance with those obtained by Wileman et al. . Seven patients needed to continue the medications for three weeks after surgery to control symptoms. None of the patients required medications on a long-term basis.
Quality of life was assessed using the SF-36 questionnaire. Among the patients who were operated, the SF-36 score for quality of life did not show statistically significant change in all the eight parameters after 3 months of conservative management. The mean score for all the 8 parameters of quality of life showed improvement at 6 months after surgery. This increase was statistically significant in the areas of social functioning, pain, and general health. Among the patients who were managed conservatively, there was statistically significant improvement in score for physical functioning, role limitation due to physical health, role limitation due to emotional problems, emotional well-being, social functioning, and general health at 3 months.
Mean score for these 6 parameters improved further at 9 months from diagnosis. Increase in mean score for pain was statistically insignificant at 3 months; however, it was statistically significant at 9 months (Table 4). In the review done by Wileman et al. , there were statistically significant improvements in the health-related quality of life at three months and one year after surgery compared to medical therapy. Table 4 Table showing changes in mean score of quality of life in operated patients. 4. Conclusion The conclusions of our prospective study of 50 patients of gastroesophageal reflux disease can be summarized as follows. In the urban Indian setup, gastroesophageal reflux disease was the most common in the age group of 20 to 40 years and both sexes were equally affected.
Lifestyle related factors like daily intake of tea or coffee, sedentary life style, spicy and oily food, nonvegetarian diet, Drug_discovery alcohol consumption and smoking/tobacco chewing may be associated with gastroesophageal reflux disease. Heartburn and regurgitation were the most common presenting symptoms in patients with gastroesophageal reflux disease. The majority of patients with gastroesophageal reflux disease had hiatal hernia and esophagitis on endoscopy. On esophageal manometry, all patients had hiatal hernia with hypotensive lower esophageal sphincter and complete relaxation of lower esophageal sphincter.