Which patients with gastroesophageal reflux disease should be referred for surgical treatment?
Janusz Jankowski, MD, PhD: Three different groups of patients should be offered surgical treatment: Those who are treated with proton pump inhibitors (PPIs) and have a very good response but do not want to stay on the treatment long-term. In fact, that is increasingly common with some of the so-called side effects of PPIs.
Some people who have a very good response to PPIs but who have side effects, maybe some osteoporosis, maybe diarrhea related to Clostridium difficile.
But also some people who get a partial response to PPIs, so they do not get rid of all the symptoms, but they have proven unequivocal evidence on pH testing that they have very severe reflux disease. These are the 3 categories that respond best.