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In a randomized, controlled trial, researchers compared treatment success with the following therapies for refractory heartburn: laparoscopic Nissen fundoplication; omeprazole with baclofen, desipramine, or both (active medical); or omeprazole with placebo (control medical). The study population comprised patients from VA gastroenterology clinics. All had persistent refractory heartburn after a 2-week trial of omeprazole 20 mg twice daily and showed abnormal acid exposure, a positive symptom association probability (SAP), or both on ambulatory pH/impedance testing while on omeprazole.
Among 366 enrolled, most were excluded, resulting in 78 undergoing randomization. At 1 year, the primary symptom endpoint was met in a significantly higher per…