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Pills, Surgery Both Effective for Chronic Reflux: Study
Date:5/18/2011

54 people with GERD who had already responded well to Nexium in a three-month try-out period prior to their entry into the study. These participants were selected because, according to one outside expert, people with reflux who do not respond to a PPI probably have another condition other than GERD.

"Those are [also] the people who tend to not do as well on surgery, because a lot of them have non-acid reflux or another cause of their symptoms," explained Dr. Amar R. Deshpande, an assistant professor of gastroenterology at the University of Miami Miller School of Medicine.

Of the 554 people selected into the trial, 372 completed five years of follow-up, including 192 randomly assigned to treatment with Nexium and 180 assigned to laparoscopic antireflux surgery.

Although the study used Nexium as its PPI, Galmiche pointed out that there is no reason why other drugs in this class wouldn't work as well.

People taking Nexium were allowed to increase their dose as needed, the investigators noted.

Five years after initiating treatment, the researchers found that GERD was in remission for 85 percent of the patients who had undergone surgery and 92 percent of the patients who were taking Nexium.

Those taking Nexium had similar levels of heartburn and acid regurgitation from the start to the end of the study. However, these symptoms lessened among those who had surgery, the researchers noted.

For example, at five years, 13 percent of those taking Nexium had acid regurgitation compared with 2 percent of those who underwent surgery. Yet there was no significant difference between the groups in the severity of heartburn, abdominal pain or diarrhea, the investigators found.

In terms of complications, 11 percent of the surgery patients had difficulty swallowing, compared with 5 percent of those taking Nexium. Among those having surgery, more suffered bloating than those taking Nexium (40 percent versus 28 percent) and the same
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