Antireflux Surgery vs. Esomeprazole for Treatment of GERD

GERD patients treated with laparoscopic antireflux surgery had results comparable to those treated with esomeprazole, but that is not the end of the story.

The merits of surgical versus medical therapy for gastroesophageal reflux disease are the subject of a long-standing debate between surgeons and gastroenterologists. In a recent clinical trial, long-term remission was achieved more often with surgery than with esomeprazole treatment, but a higher proportion of the surgically treated patients required additional proton-pump inhibitor (PPI) therapy (Br J Surg 2007; 94:198).

Researchers performed a randomized, open, parallel-group, multicenter trial that compared laparoscopic antireflux surgery (LARS) with medical therapy (esomeprazole) in 514 European patients whose GERD was diagnosed by endoscopy and 24-hour pH monitoring. After a 3-month run-in period with esomeprazole (40 mg daily) to verif…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors