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Omeprazole, Surgery Found Effective for Reflux Disease

More in surgery group stayed in remission, but postoperative complaints an issue

WEDNESDAY, Dec. 30 (HealthDay News) -- In patients with chronic gastroesophageal reflux disease, more patients stayed in clinical remission after anti-reflux surgery than with long-term omeprazole, though surgery was associated with postoperative complaints, according to research published in the December issue of Clinical Gastroenterology and Hepatology.

Lars Lundell, M.D., of the Karolinska University Hospital in Huddinge, Sweden, and colleagues analyzed 12-year follow-up data from patients with esophagitis, of whom 71 were randomized to omeprazole and 53 to surgery.

The researchers found that 53 percent of patients in the surgical group remained in sustained remission compared with 45 percent in the medical treatment group. Fourteen percent of the patients in the omeprazole group were referred for fundoplication, and 36 percent of surgical patients were treated with omeprazole or another proton pump inhibitor. Heartburn and regurgitation were more common with omeprazole, but dysphagia and flatulence were more common after surgery.

"The surgical therapeutic strategy was burdened by postoperative complaints that counterbalanced the improved reflux control, leading to similar scores for quality of life in the two treatment groups throughout the entire study period," the authors write. "In conclusion, both long-term therapeutic strategies for common GERD are effective and well-tolerated. Anti-reflux surgery is superior to omeprazole in controlling overall disease manifestations, but both treatments leave room for therapeutic improvement. Post-fundoplication complaints continue after surgery," the authors conclude.

The study was funded by AstraZeneca, which also employs several co-authors.

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