Quality of life assessment in reflux disease

The recognition of heartburn and acid regurgitation as manifestations of gastro-oesophageal reflux disease (GORD), and the suppression of these symptoms with therapy, represent an over-simplistic approach to the reflux patient. For GORD, as for other gastrointestinal disorders, it is evident that many patients suffer a greater impairment of well-being than has been appreciated hitherto, and that this impairment can be quantified using modern quality of life measuring techniques. Successful treatment normalizes quality of life in a manner which is substantially, but not wholly, predictable from symptom responses or the healing of oesophagitis. These observations raise the possibility that physicians' therapeutic intentions do not always match the patients' wishes. The appraisal of health status, or quality of life (QOL), is increasingly important in defining the implications of disease and for assessing the outcome of therapy. Hitherto, QOL evaluations have seemed relevant to circumstances of major physical disability and for patients receiving potentially unpleasant treatments, such as cancer chemotherapy, but it is now evident that QOL evaluation has much wider applicability, including relevance to common gastrointestinal disorders such as GORD.