From Our Archives
GERD Surgery - No Good?
Medical Editor: Dennis Lee, M.D.
A while back, the newspapers were trumpeting the story implying that surgery for gastro-esophageal reflux disease (GERD) was not as good as treatment with medication. The story was based on a study that evaluated a group of patients years after they participated in a study comparing the medical and surgical treatments of GERD. The study was published in the Journal of the American Medical Association.
The original study had been carried out from 1986 through 1988 in several veterans administration hospitals. Patients with severe GERD had been randomly selected to be treated with either medication or anti-reflux surgery (fundoplication). It was a reasonably large study (243 patients) that involved primarily men. (There were only 4 women.) The study followed the patients for two years after their selection to either surgery or medication. The 2-year study demonstrated that surgery was superior to medication, resulting in better control of symptoms, a need for less medication, and less cost overall.