Study compares 2 nonsurgical treatments for reflux disease

Jan 19, 2009

Two non-surgical, non-pharmacological treatments for gastroesophageal reflux disease (GERD) both appear effective in reducing medication use and improving voice and swallowing symptoms, according to a report in the January issue of Archives of Surgery, one of the JAMA/Archives journals. One type of therapy also appears effective for reducing heartburn and cough, whereas the other may be associated with a reduction in regurgitation.

GERD—a condition in which acid from the stomach backs up into the esophagus—is typically treated first with medications such as proton pump inhibitors, according to background information in the article. However, it may be difficult for patients to comply with or afford long-term drug therapy, and GERD returns more than 80 percent of the time when medication is discontinued. Surgical options have been available since the 1990s, and more recently, endoluminal therapies that involve entering through the body's natural passages to repair the underlying causes of GERD have become available.

One endoluminal therapy, full-thickness plication, involves using a long, narrow tool known as an endoscope to tighten the junction between the esophagus and the stomach with sutures. A second, radiofrequency therapy, delivers energy waves to the muscles of the esophagus and stomach, purportedly improving the function of the valve between the esophagus and the stomach. Louis O. Jeansonne IV, M.D., then of Emory University School of Medicine, Atlanta, and now at Ochsner Medical Center, Baton Rouge, La., and colleagues compared the effectiveness of these two therapies in 126 patients treated for GERD between 2002 and 2006.

For the first two years of the study, only radiofrequency was available; for the remainder, treatment decisions were based on patient preference, the surgeon's judgment and anatomical factors. A total of 68 patients underwent radiofrequency treatment and 58 underwent full-thickness plication. Patients were asked to report their medication use and rate their GERD symptoms before and after the procedure.

After an average of six months, follow-up data was obtained for 51 percent of patients. Among those who underwent radiofrequency treatment, on follow-up the percentage with moderate to severe heartburn decreased from 55 percent to 22 percent; medication use decreased from 84 percent to 50 percent; and decreases were also seen for swallowing difficulties, voice symptoms and cough. In the full-thickness plication group, moderate to severe heartburn decreased from 53 percent to 43 percent of patients; medication use decreased from 95 percent to 43 percent; and decreases were seen for regurgitation, voice symptoms and swallowing difficulties. There were no changes in chest pain or asthma symptoms after treatment in either group.

Paper: Arch Surg. 2009;144[1]:19-24.

Source: JAMA and Archives Journals

Explore further: Big strides made in fighting TB, says WHO

add to favorites email to friend print save as pdf

Related Stories

MasterCard, Zwipe announce fingerprint-sensor card

14 hours ago

On Friday, MasterCard and Oslo, Norway-based Zwipe announced the launch of a contactless payment card featuring an integrated fingerprint sensor. Say goodbye to PINs. This card, they said, is the world's ...

Plastic nanoparticles also harm freshwater organisms

16 hours ago

Organisms can be negatively affected by plastic nanoparticles, not just in the seas and oceans but in freshwater bodies too. These particles slow the growth of algae, cause deformities in water fleas and impede communication ...

Atomic trigger shatters mystery of how glass deforms

16 hours ago

Throw a rock through a window made of silica glass, and the brittle, insulating oxide pane shatters. But whack a golf ball with a club made of metallic glass—a resilient conductor that looks like metal—and the glass not ...

Recommended for you

Big strides made in fighting TB, says WHO

1 hour ago

The known tally of people with tuberculosis rose last year but overall "major progress" is being made in rolling back the disease, the World Health Organization (WHO) said Wednesday.

In US, Ebola fears rise but most confident in response

6 hours ago

After two health care workers in Texas were infected with Ebola while caring for a Liberian patient, a poll Tuesday showed a rattled US public that nevertheless stayed confident in the government's response.

'Humbled' NBC cameraman recovers from Ebola

6 hours ago

A US photojournalist said Tuesday he was grateful to be alive after the hospital treating him declared him now free of Ebola, in a minor victory over the virus that has killed more than 4,500 people.

User comments : 0