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Randomized Trial of Medical Versus Surgical Treatment for Refractory Heartburn

Thursday, October 17, 2019

Submitted by

Mark Ferguson

Source

Source Name: NEJM

Source URL: https://www.nejm.org/doi/full/10.1056/NEJMoa1811424?query=TOC

Author(s)

Stuart J. Spechler, John G. Hunter, Karen M. Jones, Robert Lee, Brian R. Smith, Hiroshi Mashimo, Vivian M. Sanchez, Kerry B. Dunbar, Thai H. Pham, Uma K. Murthy, Taewan Kim, Christian S. Jackson, Jason M. Wallen, Erik C. von Rosenvinge, Jonathan P. Pearl, Loren Laine, Anthony W. Kim, Andrew M. Kaz, Roger P. Tatum, Ziad F. Gellad, Sandhya Lagoo-Deenadayalan, Joel H. Rubenstein, Amir A. Ghaferi, Wai-Kit Lo, Ronald S. Fernando, Bobby S. Chan, Shirley C. Paski, Dawn Provenzale, Donald O. Castell, David Lieberman, Rhonda F. Souza, William D. Chey, Stuart R. Warren, Anne Davis-Karim, Shelby D. Melton, Robert M. Genta, Tracey Serpi, Kousick Biswas, and Grant D. Huang

Patients with proton-pump inhibitor refractory heartburn have a multitude of underlying causes. In this randomized trial of patients with refractory heartburn, only 21% had symptoms related to gastroesophageal reflux disease. Treatments included fundoplication vs omeprazole and baclofen vs omeprazole. Success at one year was higher in the surgery group than either of the medical therapy groups (67% vs 28% vs 12%).