If one finds inflammation in the esophageal mucosa after the anti-reflux surgery, do PPI inhibitors or other medications help? Can they reduce the inflammation and therefore the risk for esophageal carcinoma in people with gastroesophageal reflux disease, even if it's treated successfully? If anti-reflux surgery is successful, it will prevent the ongoing reflux completely. It makes the PPI medication not giving any extra help. So basically, the anti-reflux surgery is enough. Dr. Jari Rasanen, MD. And the only thing that the patient needs is to be followed up by upper GI endoscopies and gastroscopies. By that we can like stay one step ahead of cancer. Dr. Jari Rasanen, MD. And if there are any signs, dysplasia in the mucosa, then we can react before it develops into cancer. This is very important to know. Dr. Jari Rasanen, MD. And in one of your publications, you also mentioned that when you investigated patients several years after the anti-reflux surgery. You found that a the expected results of gastroesophageal anti-reflux surgery were not there anymore. That is one of the problems. Although in the beginning, you are very successful in your anti-reflux surgery. So still, when times go by, after like 10 - 15 years, it is very common that the flap that is formed after fundoplication will get loose. Dr. Jari Rasanen, MD. And by that, it won't prevent reflux anymore. So basically, you cannot say to a person who is having anti-reflux surgery that it will last for the rest of his life. Only you can give a warranty of maybe 15 years, at a maximum of 20 years. After that, it is possible that you still can have reflux although you had successful surgery in the beginning. Gastroesophageal reflux disease is common. Still, it can also be a cause of death. Dr. Anton Titov, MD. Why and how people die from gastroesophageal reflux disease? You have published some important research on that topic. The gastric reflux itself is toxic to the esophageal mucosa. It means that especially when the reflux is acidic, it can cause ulcers in the esophageal mucosa. Those ulcers can even lead to perforation of the esophagus. Dr. Jari Rasanen, MD. And that's certainly a very, very dangerous situation for the patient. Another thing that is very harmful to the patient is this. Dr. Anton Titov, MD. When you have gastric reflux, that reflux can end up in your lungs. You can get aspiration pneumonia, which is also very fatal. So, these factors can be very harmful to the patients besides cancer.