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Heartburn/GERD Health Center

Medication, Surgery Both Treat Acid Reflux Well

Study: Many GERD Patients Get Relief From Either Treatment
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DeVault, who was not involved in the research, says that means the trial results probably wouldn’t apply to the 20%-40% of people with GERD whose reflux symptoms, including heartburn and regurgitation, aren’t really helped with medication.

Still, for others, Galmiche says the study may offer some guidance about the pros and cons of choosing one treatment over the other.

“The treatments are not exactly similar in terms of results,” he says. “They are not superior, but they are not exactly similar.”

Medication or Surgery for GERD?

For the study, patients diagnosed with gastoesophageal reflux disease were recruited at academic medical centers in 11 European countries. Most patients enrolled in the study had had GERD for five years or less.

Before they split the patients into treatment groups, researchers gave all participants 40 milligrams of Nexium daily for three months to test their response to the drug.

Those that reported relief of their symptoms were randomly assigned to receive either 20 milligrams of Nexium once daily -- a dose that could be increased to 40 milligrams a day if their symptoms came back -- or lapraroscopic surgery that treats acid reflux by tightening a loose muscle that acts like a valve at the top of the stomach.

“They basically pull the top of the stomach around the esophagus, so they are tightening the sphincter,” says Mouen Khashab, MD, assistant professor of medicine and director of therapeutic endoscopy at Johns Hopkins University in Baltimore.

Five years later, 92% of the 266 people in the study who were taking the Nexium, and 85% of the 288 people in the surgery group, continued to have either no symptoms or bearable reflux symptoms.

The main differences between the groups were that patients taking medication continued to experience mild GERD symptoms, including regurgitation, heartburn, and abdominal pain.

Study participants who’d had the surgery, on the other hand, reported more complete resolution of those symptoms, but more difficulty swallowing and trouble belching, a problem that can lead to bloating.

Those are differences that may be meaningful to patients who are choosing one treatment over the other, experts say.

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