Two nonsurgical procedures relieve many
symptoms of acid reflux disease including heartburn in people who are not helped
by the medications typically used to treat it, U.S. researchers said on Friday.
In this chronic condition, also called gastroesophageal reflux disease,
or GERD, stomach acid backs up into the esophagus, irritating its lining and
causing inflammation. Persistent, often-severe heartburn is the most common
symptom.
Most people are helped if they take a class of drugs called proton pump
inhibitors such as AstraZeneca Plc's Nexium and Prilosec, Wyeth's Protonix,
Takeda Pharmaceutical Co's Prevacid and Eisai Inc's Aciphex.
For those who are not helped by medications, there are few options short
of surgery.
The new study, published in the journal Archives of Surgery, found two
rarely performed so-called endoluminal therapies reduced heartburn, swallowing
difficulties and voice hoarseness in many patients who underwent them.
Both are done using an endoscope, a long flexible instrument inserted
through the mouth and down the esophagus.
One procedure called full-thickness plication uses the endoscope to
tighten the junction between the esophagus and the stomach with sutures. The
other, called radiofrequency therapy, uses heat to improve the function of the
valve between the esophagus and stomach.
In this study, 68 patients underwent radiofrequency treatment and 58 had
full-thickness plication.
"I think medication is still the first thing that people should try for
reflux," Dr. Louis Jeansonne IV of Ochsner Medical Center, Baton Rouge,
Louisiana, one of the researchers, said in a telephone interview.
"Surgery is still the most effective treatment in people who don't have
relief with medications. But this study shows that this therapy without surgery
is a viable option in patients who either can't have surgery or don't want
surgery," Jeansonne added.
Surgery used to treat acid reflux is called laparoscopic fundoplication,
in which doctors take the top of the stomach and wrap it around the lower part
of the esophagus to create a barrier for acid reflux.
Acid reflux returns more than 80 percent of the time when people stop
taking the medications.
"It's nice to be able to offer something less invasive," said Dr. Edward
Lin of Emory University School of Medicine in Atlanta, another of the
researchers.
Lin noted the two nonsurgical treatments are uncommon in part because
health insurance companies typically do not pay for them. Lin added that these
nonsurgical treatments do not preclude a patient from getting surgery later if
they do not provide relief.
(Editing by Julie Steenhuysen and Todd Eastham) Keywords: HEARTBURN
TREATMENT
(Reuters messaging: will.dunham@reuters.com; +1 202 898 8300)
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