Surgery Versus Drugs to Treat GERD

Medically Reviewed

Drugs known as proton pump inhibitors (PPIs) are usually the first therapy recommended to people with gastroesophageal reflux disease (GERD). The medication is effective at controlling heartburn, which is caused by a faulty lower esophageal sphincter that allows stomach contents to back up into the esophagus.

Besides medication, another option for controlling GERD symptoms is surgery, which involves wrapping part of the stomach around the lower esophagus to reinforce the esophageal sphincter.

In a recent study comparing laparoscopic anti-reflux surgery with the PPI esomeprazole, researchers found both treatments brought acid exposure to a near-normal level.

In another recent study, researchers reported long-term results in 100 patients who received a magnetic sphincter augmentation device, a band of linked titanium beads with magnetic cores placed around the esophagus, just over the stomach.

The beads expand when people swallow, and contract after swallowing to prevent reflux. The device, which has been approved by the U.S. Food and Drug Administration, helped patients control their reflux, with few side effects, for five years after placement of the device.

Bottom line

If you take PPIs for GERD but find they don’t fully control your symptoms, or if you’re concerned about long-term use, talk with your doctor.

Surgical procedures to correct GERD should be done when all else fails or medications are not tolerated. Most long-term studies show that surgery and medical treatment are equally beneficial. And there are potential complications from all types of surgery; some people need to resume medication after surgery.

Source: Clinical Gastroenterology and Hepatology, Volume 14, pages 671, 678, May 2016