Surgery Might Not Mean End of Acid Reflux

Proton pump inhibitors used for years by more than half of patients after anti reflux surgery

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Anti-reflux surgery should relieve symptoms and break dependence on medication, right?

Despite having anti-reflux surgery, people report still using medications called proton pump inhibitors (PPIs) to control their reflux symptoms.

A recent study investigated the use of PPIs after anti-reflux surgery and found that their use was much more common than originally thought.

"Talk to your surgeon about all possible outcomes after reflux surgery."

Anders Lødrup from the University of Copenhagen in Denmark was the lead author of this study.

The study used data on 3,465 patients who had anti-reflux surgery in Denmark between 1996 and 2010. Information on PPI prescriptions filled by the participants was found in the Danish National Prescription Registry.

Results of this study showed that at least one prescription for a PPI was filled by 66 percent of the patients after surgery. The chance of getting a PPI prescription filled was 57 percent in the first five years after surgery, 72 percent after 10 years and 83 percent after 15 years.

An average of at least half a dose of  a PPI per day or 180 doses per year was taken by 38 percent of the patients during the study periods analyzed. The research team called this use long-term use of PPIs. Ten years after anti-reflux surgery, the chance of long-term PPI use was almost 57 percent.

Long-term PPI use was 35 percent more likely in women than in men, and that likelihood increased with age. The odds of someone age 70 to 80 using PPIs long term were almost double that of a 40-year-old. For those over age 81, the odds were over four times those of a 40-year-old.

This study pointed out that 40 percent of the people who had surgery did not use PPIs regularly in the year before their surgery, yet 28 percent used PPIs long term after their surgery.

The researchers suggested that "a proportion of these patients could have benefitted from PPI therapy before [anti-reflux surgery] and maybe even have been managed without surgery."

The authors wrote, "Based on the findings from our study, we believe that patients considering anti-reflux surgery should be informed of the high risk of postsurgical long-term PPI use."

The research team cited several limitations of their study. These researchers noted that getting a prescription filled did not necessarily mean the patients took the medicine. The study did not take into account any over-the-counter anti-reflux medications taken by the participants.

This study was published in the January issue of Gut.

Funding for the study was provided by Region Zealand's Health Sciences Research Foundation.

Review Date: 
February 18, 2014
Last Updated:
February 21, 2014