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
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