PAEA Surgery End Of Rotation (EOR) Practice Exam

What complication could lead to surgery in a patient with esophageal reflux?

1. Weight gain

2. Failure of medical therapy

3. Increased appetite

4. Chronic cough

The correct answer is: Failure of medical therapy

In patients with esophageal reflux, the failure of medical therapy is a significant complication that may necessitate surgical intervention. Management of esophageal reflux often begins with lifestyle modifications and pharmacological treatments, such as proton pump inhibitors or H2 receptor antagonists. When these medical therapies do not effectively control symptoms or prevent complications, such as esophagitis or Barrett's esophagus, surgery becomes an option to help alleviate the condition. Surgical procedures like fundoplication can provide a more permanent solution by enhancing the barrier to gastroesophageal reflux. This surgery creates a new angle of the esophagus to the stomach, effectively reducing the likelihood of reflux. Therefore, when medical management fails, opting for surgical intervention becomes a clinical consideration to improve the patient's quality of life and prevent further complications arising from untreated reflux. Weight gain, increased appetite, and chronic cough might be associated with the condition or its symptoms but do not directly indicate a failure of medical therapy or necessarily lead to surgical intervention on their own.