Navigation Links
No One Treatment for Acid Reflux Clearly Better Than Another: Study

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 wrap the upper portion of the stomach around the esophagus," explained Kato. "The idea here is to provide a bit of a barrier to stop the stomach acid from washing back up into esophagus."

There were fewer studies on fundoplication than on drugs but the studies that were done "suggested that for some patients, surgery did help control some of their symptoms a little bit better but in general didn't allow them to completely stop taking medications," Kato said.

There were also more severe side effects, including infections and difficulty swallowing.

There was much less information on a third treatment, which is essentially fundoplication done using an endoscope. There weren't enough data to come to any conclusions about its effectiveness, Kato said.

"I would say endoscopic therapies for GERD are really minimally utilized at this point in time ... and the data would suggest that, at best, it's fair-to-moderately effective," added Dr. Thomas Watson, chief of thoracic surgery at the University of Rochester Medical Center in New York.

Nor was it clear to the authors of the report which patients would do better with which type of treatment, which treatment might better prevent long-term complications such as cancer, or which treatment was safer over the long haul.

"There are no clear-cut guidelines," Watson said. "It comes down to the severity of the disease, the age of the patient, their desires, their willingness or unwillingness to stay on long-term therapy, as well as their willingness or unwillingness to undergo surgery."

Added Dr. Benjamin Havemann, an assistant professor of internal medicine at Texas A & M Health Science Center College of Medicine: "This [study] does make the case for patients making an educated decision in partnership with their treating gastroenterologist and surgeon. What we're left with is two compelling treatments for GERD [fundoplication and medication], which have similar efficacy. In the end, in the absence of a gold standard, it is important that management strategies for GERD be tailored to the individual patient."

More Information

AHRQ also has consumer pamphlets on treatments for GERD.

SOURCES: Elisabeth Kato, M.D., medical officer, AHRQ; Benjamin Havemann, M.D., assistant professor of internal medicine, Texas A & M Health Science Center College of Medicine and director, Round Rock Division of Gastroenterology, Scott & White Healthcare; Thomas Watson, M.D., chief, thoracic surgery, University of Rochester Medical Center; Sept. 23, 2011, report, "Comparative Effectiveness of Management Strategies for Adults with Gastroesophageal Reflux Disease"

Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Hepatitis C patients likely to falter in adherence to treatment regimen over time, Penn study shows
2. Potential treatment for pink eye epidemic
3. Treatment of common virus can reduce tumour growth
4. Wayne State researcher developing treatments for Parkinsons with aid of $2.15 million NIH grant
5. Autism Speaks Autism Treatment Network receives $12 million AIR-P grant
6. Study shows decisions over life-sustaining treatment are likely to change
7. Couples counseling improves sexual intimacy after prostate treatment
8. Treatment of rectal cancer varies enormously between different European countries
9. New treatment for kala azar, the most deadly parasitic disease after malaria
10. Heart drug offers possible treatment for patients facing respiratory failure
11. Elderly breast cancer patients risk treatment discrimination
Post Your Comments:
(Date:11/26/2015)... ... November 26, 2015 , ... ... wellness consultation, has collaborated with Women’s Web – an online resource for ... topics on mental and emotional well-being relationship, life balance, stress, professional development, ...
(Date:11/25/2015)... ... November 25, 2015 , ... The holiday season is ... pleasing the palates of attendees is of the utmost importance. Whether you are ... get-together, give these recipes a try this holiday season. , Turkey Croquettes , ...
(Date:11/25/2015)... Vegas, NV (PRWEB) , ... November 25, 2015 , ... ... invites patients to learn more about hair loss treatment with the Capillus272™ Pro laser ... an effective solution for thicker and fuller hair, without the need for surgery, prescription ...
(Date:11/25/2015)... ... 2015 , ... According to an article published November 10th by ... heralded as a breakthrough for performing hernia repairs. The article explains that the biggest ... that it can greatly reduce the pain that a patient might otherwise experience after ...
(Date:11/25/2015)... Florida (PRWEB) , ... November 25, 2015 , ... ... testing for physicians and athletic programs, launches new Wimbledon Athletics Facebook ... of testing young athletes for unsuspected cardiac abnormalities. About 2,000 people under the ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)...  Amgen (NASDAQ: AMGN ) today announced the ... the United States (U.S.) Food and ... to Humira ® (adalimumab). Amgen believes this submission ... FDA and represents Amgen,s first BLA submission using the ... M.D., executive vice president of Research and Development at ...
(Date:11/25/2015)... 25, 2015  Linden Care, LLC, a retail specialty ... for patients suffering from chronic pain, said today that ... Restraining Order (TRO) enjoining Express Scripts from unilaterally terminating ... --> --> The company ... legal options. --> --> ...
(Date:11/25/2015)... -- On Tuesday, November 24, 2015, the jury ... Medical Technology, Inc. for product liability and misrepresentation ... device, awarded $11 million in favor of Plaintiff ... three days of deliberations, the jury found that ... and unreasonably dangerous, and that Wright Medical made ...
Breaking Medicine Technology: