A new study from the Canadian Journal of Gastroenterology examined the difference in cost between surgery (laparoscopic Nissen Fundoplication) or the Stretta (non evasive surgery) vs. medication with a Proton Pump Inhibitor (PPI). The researchers also looked at the patient's symptoms and quality of life for each treatment approach.
A patient with long term symptoms of Gastroesophageal Reflux Disease (GERD) often tries many treatments. Changes to the diet and lifestyle may be the first line of treatment while medications are often prescribed for long term prevention of heartburn and to reduce inflammation of the esophagus, leading to damage. Treatment of this chronic condition may go on for months or years.
The results showed that medication (PPI's) produced the best symptom relief at the lowest cost for the patients in the study. However, the Nissen Fundoplication surgery was rated the highest for improving quality of life. At the same time, it was much more costly than long term medication treatment and equal to the cost of the Stretta.
Patients with long term symptoms and complications from GERD often face the dilemma of continuing on long term medication or considering surgery. Some patients worry about using medication for months and years and seek an alternative treatment to reduce or eliminate medication.
For some patients, the medication helps but not enough. While Proton Pump Inhibitors (PPI's) have a proven track record for reducing acid and reducing symptoms, there is a small group of patients who continue to have worrisome symptoms regardless of the dose of medication. It isn't clear why this happens, leaving doctors and patients frustrated and confused. The patients who have "tried everything" may be more inclined to consider surgery. Certainly, this study shows a high level of patient satisfaction with surgery despite the cost.
If you are on long term medication treatment for GERD, it is a good idea to discuss the GERD treatment plan with your gastroenterologist at each visit. As symptoms and treatments change, you and your doctor can decide if another approach is needed. Certainly, medical treatment is changing at a rapid rate. Your doctor is in the best position to evaluate trends and treatments that may benefit you.