118

Profile of GERD: Familiarity with the disease, its symptoms and itscomplicationsRamesh Srinivasan1, Radu I Tutuian1, Marcelo F Vela1, T Isaac2, IGalaria2, June Castell1, Philip O Katz1 and Donald O Castell1*.1Medicine, Graduate Hospital, Philadelphia, PA, United States; and2Medicine, Thomas Jefferson University, Philadelphia, PA, UnitedStates.

Purpose: To assess in an urban population: 1) familiarity with GERD, 2)knowledge of symptoms 3) knowledge of its complications, and 4) sourceof GERD-related information.Background: Recent development in both diagnosis and treatment ofGERD has led to a large increase in information available to the generalpublic about this disease.Methods: 410 subject sample from Philadelphia having demographicscomparable to the Philadelphia 1990 census filled an 84-item in-personquestionnaire regarding heartburn.Results: Familiarity: 49.8% of the population had heard of GERD. Therewas no difference in this number when the data were analyzed at by gender,race or age. Those with GERD symptoms were more likely to be familiarwith GERD (66% v 43%, p � 0.01).

Only 2-6% incorrectly identified non-GERD symptoms (i.e. hair loss;frequent urination), however only 10-20% correctly recognized GERD-related symptoms (i.e. difficulty swallowing; vomiting) 69.3% identifiedulcer as possible complication of GERD, however stroke (33.2%) wasconsidered as likely as cancer (31.7%) to be identified as a complication.The media (TV 53%, printed ads 41%) is more likely to be the main sourceof information than physicians (33%).Summary: While awareness of GERD is relatively high, awareness ofsymptoms is low. Particularly troubling is the failure to recognize cancer asa complication.Conclusions: Despite the recent media blitz the general population is notreceiving adequate information about GERD. Physicians need to be moreinvolved in public education.

119

Profile of GERD: Prevalence of symptoms and its social impactRamesh Srinivasan1, Radu I Tutuian1, Marcelo F Vela1, T Isaac2, IGalaria2, June Castell1, Philip O Katz1* and Donald O Castell1.1Medicine, Graduate Hospital, Philadelphia, PA, United States; and2Medicine, Thomas Jefferson University, Philadelphia, PA, UnitedStates.

Purpose: To assess in an urban population: 1) prevalence of GERD relatedsymptoms; 2) social impact of GERD related symptoms.Methods: A sample from Philadelphia (410 subjects, with demographicscomparable to the Philadelphia 1990 census) filled an 84-item in-personquestionnaire regarding heartburn. The data were analyzed as a whole,subdivided by gender, race and ages.Results: 49.3% of the total population reported heartburn at least occa-sionally. This percentage was the same regardless of gender or race. Only37% of those over 60 reported this symptom. In people diagnosed withGERD 84% reported this symptom.

Total 60� Dx GERD

HB postprandial 42% 34% 77%HB night time 34% 29% 61%Regurgitation 23% 19% 61%

For these more specific symptoms there were no differences by gender orrace.

Heartburn symptoms affected enjoyment of a social situation in 16% ofthe total population; again no differences when evaluated at by gender orrace but only 9% of those over 60 were affected. The frequency ofdisrupted social situations however is low: 6% of the total being affected

weekly or more. There is no difference by race, however 10% of womenvs. 3% of males and 4% �60 vs. 8% �60 are affected at least weekly. 7%of the total do not take part in public activities involving food (2% �60years, 30% Dx GERD) and 4% have missed work due to symptoms (1%�60, 16% Dx GERD).Conclusions: Prevalence of heartburn in Philadelphia is similar to thatreported elsewhere for the US population. This is the first report thatprevalent symptoms are same regardless of gender or race. It is interestingto note that symptoms decrease with age. A previous diagnosis of GERDshows an expected increase in symptoms and decrease quality of life.

120

High patient satisfaction with laparoscopic myotomy for thetreatment of achalasiaIan M Storch1, Lisa A Lih-Brody2, Adam J Goodman1, Robert Ward2

and Matthew J McKinley2*. 1Medicine, North Shore UniversityHospital, Manhasset, NY, United States; and 2Medicine and Surgery,ProHealth Care Associates, Lake Success, NY, United States.

Purpose: To evaluate patient satisfaction with the currently availabletreatment modalities for achalasia by using a retrospective patient interviewin a community based practice.Methods: A total of 21 patients with achalasia as defined by standardmanometric criteria were included. Mean age of the patients was 55(25–90), there were 7 men and 14 women. Treatments included laparo-scopic myotomy (11), botox (17), and balloon dilation (8). Mean time fromthe last procedure was 23 months (1–96). A retrospective patient satisfac-tion survey was devised which included assessment of symptoms such asdysphagia, regurgitation, vomiting, chest pain, bad taste, cough and heart-burn. Symptoms were assessed pre and post therapy, classified as none,mild, moderate and severe. Symptoms were also assessed in regard tofrequency and expressed as a symptom score. Time to return to functionalstatus after therapy and future treatment plans were discussed.Results: AVERAGE SYMPTOM SCORES: SEE TABLEConclusions: Patients have the greatest satisfaction following therapy forachalasia with laparoscopic myotomy as compared with botox or balloondilation. Laprascopic myotomy was well tolerated and patients returned tofunctional status within a mean of 2 weeks.

Myotomy Botox Dilation

Before After Before After Before After

Dysphagia 2.0 0.36 3.0 2.5 2.6 1.5Regurgitation 2.25 0.04 2.0 1.75 1.5 0.5Vomiting 0.63 0.0 0.0 0.0 0.75 0.62Chest pain 0.73 0.18 0.0 0.0 1.5 1.1Bad taste 0.63 0.0 1.0 0.0 0.12 0.25Cough 0.45 0.0 0.0 0.0 0.5 0.37Heartburn 1.7 0.64 4.0 0.5 0.88 0.62

121

Gastroesophageal reflux disease & cough-their relationshipdetermined by concurrent ambulatory esophageal pH andmanometry monitoringCG Streets MD, PF Crookes MD, TR DeMeester MD, JH Peters MD,JA Hagen MD, SR DeMeester MD, CG Bremner MD Department ofSurgery, University of Southern California, Los Angeles.

Purpose: The relationship between chronic cough & gastroesophagealreflux disease (GERD) is confusing. A cough, by increasing intra-abdom-inal pressure, may overcome the lower esophageal sphincter (LES) andcause reflux; or a primary reflux event may result in cough by reflex oraspiration. Although subjects inaccurately record coughs, these events canbe more precisely identified using manometry. Therefore, concurrent am-bulatory multiple level esophageal pH and manometry monitoring wereused to clarify the relationship between reflux and cough.

S39AJG – September, Suppl., 2001 Abstracts