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GERD surgery vs PPIs

This article was originally published in The Tan Sheet

Executive Summary

Patients with gastroesophageal reflux disease (GERD) who opt for the surgical procedure laparoscopic Nissen fundoplication (LNF) have fewer symptoms long-term than those who manage their condition with proton-pump inhibitors like Prilosec OTC, according to research presented during Digestive Disease Week in Los Angeles, Calif. The study randomly divided 98 chronic GERD patients requiring long-term therapy. One group was treated with PPI, and the other underwent LNF. The researchers checked symptoms every three months and conducted a 24-hour pH test after one year. While symptoms and pH levels improved in both the PPI and surgery groups, the one-year follow up showed surgical patients experienced a significant improvement in symptoms, climbing from 73.3 to 90.2 on a 100-point global rating scale that measured patient satisfaction with symptom control, Mehran Anvari, McMaster University in Ontario, et al., conclude. Meanwhile, the PPI patients' symptoms remained stable. "This minimally invasive surgical procedure may allow some patients to manage GERD symptoms and forego a long-term drug regimen." The study runs counter to a report from Tufts-New England Medical Center Evidence-based Practice Center that concluded that PPIs and surgery are similar in relieving symptoms and decreasing esophageal acid exposure 1("The Tan Sheet" Dec. 19, 2005, p. 5)...

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