PPI Meds and Surgery Both Control GERD
Do you suffer from chronic gastroesophageal reflux disease symptoms? Ask your GI doctor whether you may be able to avoid a surgical solution. A new study has revealed that proton pump inhibitor (PPI) drugs can offer relief comparable to laparoscopic anti-reflux surgery. The five year study tracked long-term results for over 370 patients randomly assigned to receive either surgery or regular doses of the PPI medication esomeprazole (Nexium).
Only 15% of the patients who had surgery experienced a recurrence of GERD symptoms severe enough to require additional treatment. The ongoing control provided by PPI drugs was slightly better for this small study – with just 8% of patients on Nexium needing further intervention. Researchers now consider both GERD therapies equally effective.
How Do PPIs Work?
PPI medications such as Prilosec, Prevacid, and Nexium block the activity of the enzymes in your stomach wall that produce acid. This suppression of acid production gives the lining of the stomach time to heal and reduces heartburn symptoms. PPIs don’t work for all patients. For example, they may not be effective for controlling reflux when GERD is not the underlying cause. This means it’s important to consult with a gastrointestional specialist to determine the source of your reflux rather than simply taking over the counter PPIs for ongoing symptoms.
Pros and Cons of PPI vs. Surgery
Since PPIs and surgery both work, you can choose a treatment based on your preferences (if you don’t have other medical issues that would make one approach better than the other). Here are some of the benefits and drawbacks of each method:
Laparoscopic surgery is minimally invasive but carries some risks including infrequent but serious complications such as bowel obstruction or infection. It’s much more expensive than medication which may place it out of reach if you don’t have medical insurance. The surgery will also leave scars. Patients in the study mentioned above reported more frequent problems such as bloating, flatulence, and difficulty swallowing. On the plus side, barring unforeseen complications, you will only need one operation for lasting results.
PPI medication is less costly and does not present the type of risks associated with surgery. However, you must continue taking the drug to keep severe GERD symptoms in check. Of course, if you feel anxious about having an operation, taking a pill each day may not seem like much of an inconvenience. Patients using Nexium in the recent study had more acid regurgitation over the long term than those who had surgery. PPI drugs do carry a risk of side effects (including loss of bone density with long term use that may increase the risk of hip fractures in older patients). However, these medications are well tolerated by many patients.
If you like to learn more please give us a call 310.271.1122 or you can fill out our online Request an Appointment form to schedule your consultation.