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Medication Vs Surgery For Acid Reflux

For years, the two most prevalent strategies for treating chronic gastroesophogeal reflux disease — commonly known as ‘acid reflux’ — have been prescription medications and surgery. Now, after a more than decade-long study in Sweden, researchers say that while both forms of treatment can be successful, each comes with its own unique set of advantages and disadvantages.

Acid reflux disease occurs when the acidic digestive fluids in the stomach are regurgitated into the esophagus and mouth, resulting in unpleasant inflammation and, in severe cases, permanent damage to the esophageal lining.

At the Karolinska University Hospital in Huddinge, Swedish researchers began studying 255 patients with acid reflux disease some 12 years ago. Roughly half of the patients had undergone surgery to treat the disease while the other half opted for non-invasive therapy with the prescription drug omeprazole — known more widely by its brand name Prilosec.

Though originally intended to be a 5 year study, Dr. Lars Lundell who headed the study says that he and his colleagues are still in regular contact with 53 patients from the surgery group and 71 from the Prilosec group.

After over a decade of follow-up exams and interviews with patients, Lundell says he has observed that “both treatments leave room for therapeutic improvement.”

In a report of his team’s findings in the journal Clinical Gastroenterology and Hepatology, Dr. Lundell and colleagues wrote that slightly over half of the 53 patients who had undergone surgery were still acid-reflux-free, while around 45 percent of those who took medication were also still in remission.

While surgery appeared to be a moderately more successful strategy for long-term management of the disease, Lundell pointed out that there were other complications associated with surgery — such as chronic flatulence, difficulties with swallowing and loss of ability to belch or vomit — that may balance out its slightly higher margin of success.

Significantly, Lundell’s team also noted that the abovementioned postoperative complaints did not go away over time, also pointing out that nearly 40 percent of the surgical patients also ended up taking some kind of medication to reduce their production stomach acids.

In an e-mail exchange with Reuters Health, Lundell recognized that the average reader of the study would probably interpret the results to mean that proper treatment with omeprazole is more or less as effective as surgery.

Dr. Stuart Jon Spechler, health commentator and gastroenterologist at the University of Texas Southwestern Medical Center in Dallas commented that he found it, “difficult to fathom” why any patient suffering from acid reflux would choose to “opt for a potentially hazardous surgery to fix a problem managed almost as well by a reasonably safe medication.”

Lundell’s study also included quality-of-life scores for patients that corroborated the report’s other findings, recording “similar” ratings for quality-of-life for both forms of treatment.

The group’s study was sponsored by the pharmaceutical giant AstraZeneca, manufacturer and marketer of Prilosec.

Source: Red Orbit: Jan 10 2010


By Mortin - Copyright 2010
Last modification 05/02/2010