Medication, Surgery Both Treat Acid Reflux Well
Study: Many GERD Patients Get Relief From Either Treatment
Medication or Surgery for GERD? continued...
In reading the study, Walter W. Chan, MD, MPH, an instructor of medicine at Harvard Medical School and a gastroenterologist at Brigham and Women’s Hospital in Boston, says it seemed to him like the surgical patients had better resolution of their symptoms.
“I think it’s a well-done, well-designed study. I just don’t think that you can draw the conclusion that taking medication one or two times a day is just as good as undergoing surgery,” he tells WebMD.
And Chan notes that there have been concerns about the safety of proton pump inhibitors when they are taken long-term. Some studies have suggested they may increase the risk of fractures and infections, for example.
Other experts noted that the surgical results achieved in the study depend on finding an experienced surgeon and having the procedure done at a medical center that does many of them.
“It generally works very well if you chose the patients correctly and send the patients to the right surgeon,” says Khashab.
But the procedure does have risks, he says. In some cases, the repair may be too tight and gas can’t escape from the stomach, a problem called gas-bloat syndrome. Patients may also experience difficulty getting food to go down into the stomach, or dysphagia. Those problems can be corrected with a revision procedure.
And the fix may not be permanent. Most patients will see their symptoms return five to 10 years after their procedure. In those cases, the wrap can be tightened with another procedure, or they may return to taking medication.
Another consideration may be cost.
Several studies that have compared the out-of-pocket costs for patients taking proton pump inhibitor medications and acid reflux surgery find that the surgery costs more, even when costs are stretched over years.
In a Canadian study published in 2011, for example, which followed patients who either took proton pump inhibitors or had surgery to correct their acid reflux for three years, the surgery cost about $3,000 more than the medical costs, including doctors’ visits, incurred taking the medication.