Study compares 2 nonsurgical treatments for reflux disease

January 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: Abusive avatars help schizophrenics fight 'voices': study

Related Stories

Abusive avatars help schizophrenics fight 'voices': study

November 24, 2017
"You're rubbish. You're rubbish. You're a waste of space." The computer avatar pulls no punches as it lays into the young woman, a schizophrenia sufferer, facing the screen.

Health service complaints system risking patients' and doctors' health

November 22, 2017
The General Medical Council (GMC) regulates doctors in the UK and can stop or limit their rights to practice. Around 9000 doctors a year are reported to the GMC, and around 160 are suspended or erased from the medical register.

Simple EKG can determine whether patient has depression or bipolar disorder

November 20, 2017
A groundbreaking Loyola Medicine study suggests that a simple 15-minute electrocardiogram could help a physician determine whether a patient has major depression or bipolar disorder.

Clearer communication by GPs could speed up cancer diagnosis

November 20, 2017
Deciding when to return to the GP when symptoms do not resolve is something many people struggle with, especially when the symptoms may not appear to be serious or life-threatening. Research with cancer patents in Denmark, ...

'It never really leaves you.' Opioids haunt users' recovery

November 20, 2017
It's hard to say whether businessman Kyle Graves hit rock bottom when he shot himself in the ankle so emergency room doctors would feed his opioid habit or when he broke into a safe to steal his father's cancer pain medicine.

Good mental health critical to military readiness

November 22, 2017
Mental health is a critical part of every Airman's medical readiness. Although many service members worry that seeking mental health care will negatively effect their career, the opposite is usually true. With early identification ...

Recommended for you

Study opens new avenue in quest to develop tuberculosis vaccine

November 24, 2017
A team of scientists led by the University of Southampton has taken an important step forward in research efforts that could one day lead to an effective vaccine against the world's deadliest infectious disease.

Four simple tests could help GPs spot pneumonia and reduce unnecessary antibiotics

November 23, 2017
Testing for fever, high pulse rate, crackly breath sounds, and low oxygen levels could be key to helping GPs distinguish pneumonia from less serious infections, according to a large study published in the European Respiratory ...

New approach to tracking how deadly 'superbugs' travel could slow their spread

November 22, 2017
Killer bacteria - ones that have out-evolved our best antibiotics—may not go away anytime soon. But a new approach to tracking their spread could eventually give us a fighting chance to keep their death toll down.

Research points to diagnostic test for top cause of liver transplant in kids

November 22, 2017
Biliary atresia is the most common cause of liver transplants for children in the United States. Now researchers report in Science Translational Medicine finding a strong biomarker candidate that could be used for earlier ...

Alcohol consumption and metabolic factors act together to increase the risk of severe liver disease

November 22, 2017
A new study provides insights into the interaction between alcohol consumption and metabolic factors in predicting severe liver disease in the general population. The findings, which are published in Hepatology, indicate ...

Metabolites altered in chronic kidney disease

November 22, 2017
Chronic kidney disease (CKD) affects 1 in 7 people in the United States, according to the U.S. National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK). These individuals have a very high risk of cardiovascular ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.