Surgery More Effective than Medication for GERD

Stomach wrap operations, in which surgeons wrap part of the stomach around the lower part of the gullet, may be a more effective treatment for GERD than medication, at least in the short-to-medium term.

A group of researchers from the University of Aberdeen, UK aimed to determine if this surgical procedure, also known as fundoplication, is more effective in treating GERD than changes to diet and acid suppression tablets. Led by Samantha Wileman of the Health Services Research Unit at the university, the group reviewed data from four trials of 1,232 patients. Based on one year of follow up, patients who underwent fundoplication operations that were performed by keyhole surgery experienced more effective reduction of their GERD symptoms than patients who were treated with medication and diet changes.

“All four studies reported significant improvements in GERD-specific QOL after surgery compared to medical therapy, although data were not combined,” the researchers wrote in the current issue of Cochrane Reviews. “There is evidence to suggest that symptoms of heartburn, reflux and bloating are improved after surgery compared to medical therapy, but a small proportion of participants have persistent postoperative dysphagia.”

The researchers add that, although the overall rate of postoperative complications was low, “surgery is not without risk, and postoperative adverse events occurred, although they were uncommon.” The cost of the surgery is also much greater than treating GERD with diet changes and medication, the researchers noted.

“There is evidence to suggest that, at least in the short to medium term, surgery is more effective than tablets for treatment of GERD,” said Wileman. “But surgery does carry a risk and whether this is outweighed by the benefits in the long term is still not certain.”