Take the Pill or Go under the Knife?

Acid reflux controlled equally well by both drugs and surgery

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) In many cases, there is more than one way to fight a health problem. Some may work better than others. But when dealing with acid reflux (the condition that causes heartburn), both drugs and surgery helped patients.

One way acid reflux patients can fight their disease is to take drugs over a long period of time. Another way is a certain type of surgery. Both options can control the disease for five years, according to recent findings.

"Either surgery and drugs keep heartburn at bay for five years."

Only a few past studies have compared drug treatment for acid reflux to surgery for the same problem. This study compared the use of a drug called Nexium (esomeprazole) to a surgery called laparoscopic antireflux surgery (LARS).

According to the study's authors, some patients worry about having to take long-term medication, so they choose the surgery instead. This study shows that patients may not need to worry so much, as both treatments lead to similar results.

One difference between the two treatments, however, was that patients who underwent surgery had less heartburn symptoms at the end of 5 years, compared to those taking medication.

However, surgery patients had more difficulty swallowing compared to the drug treatment group.

Altogether, the study's findings show that modern treatments for acid reflux are successful over the long-term for most patients.

The Study

  • Researchers compared disease-control capabilities of Nexium (a proton pump inhibitor) versus LARS
  • The 5-year randomized trial included 192 patients assigned to take Nexium and 180 who were assigned to undergo LARS
  • 85 percent of the patients who underwent LARS had their acid reflux in remission 5 years after surgery
  • 92 percent of the patients who took Nexium remained in remission at 5 years
  • 13 percent of the Nexium group had acid regurgitation at 5 years, compared to only 2 percent of the LARS group
  • 16 percent of the Nexium group had heartburn, compared to 8 percent of the LARS group (not a significant difference)
  • Both groups had the same level of abdominal pain
  • Both groups had similar levels of diarrhea
  • 11 percent of LARS patients had dysphagia (difficulty swallowing), compared to 5 percent of the Nexium group
  • 40 percent of the LARS group had bloating, compared to 28 percent of the Nexium group
  • 57 percent of the LARS group had flatulence, compared to 40 percent of the Nexium group 
Reviewed by: 
Review Date: 
May 18, 2011
Last Updated:
May 26, 2011