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No One Treatment for Acid Reflux Clearly Better Than Another: Study
Date:9/29/2011

By Amanda Gardner
HealthDay Reporter

THURSDAY, Sept. 29 (HealthDay News) -- Medications are effective for most patients with acid reflux disease, but some surgical options may be just as effective, according to a review of studies on current treatments for this common condition.

Acid reflux disease, also known as gastroesophageal reflux disease or GERD, occurs when the contents of the stomach -- including burning acid -- chronically spill up into the esophagus, causing heartburn and other symptoms such as a persistent cough, laryngitis and asthma.

Acid reflux disease may afflict as many as 4 percent of Americans, resulting not only in a sometimes significant financial drain but also more serious long-term consequences such as esophageal cancer, according to background information in the report released Sept. 23 by the U.S. Agency for Healthcare Research & Quality (AHRQ), part of the U.S. Department of Health & Human Services.

Obesity, which is widespread globally and growing, probably ups the risk for GERD.

The authors of the report looked at three categories of treatment: medications; a type of surgery known as fundoplication, often done laparoscopically; and fundoplication done using an endoscope, or lighted tube, to guide surgeons.

Two classes of drugs are the mainstay of treatment for GERD: proton pump inhibitors (PPIs) such as Nexium (esomeprazole), Prevacid (lansoprazole) and Prilosec (omeprazole), and histamine-2 receptor antagonists (H2RAs), such as Tagamet (cimetidine) and Pepcid (famotidine).

PPIs tended to be the more effective of the two drugs but there wasn't much of a difference between different PPIs or dosages, said Dr. Elisabeth Kato, a medical officer at AHRQ.

And generally side effects weren't all that serious, although use of PPIs has been associated with an increased risk of some bacterial infections and fractures.

Fundoplication is "surgery to wr
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