A plain-language publication from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) compare the benefits and risks of treatments for gastroesophageal reflux disease (GERD). The 2011 publication, Comparative Effectiveness of Management Strategies for Adults with Gastroesophageal Reflux Disease, is based on an updated evidence report.
GERD can be treated with medications or surgery. The report concluded that established drug-based therapy is effective. The report found that proton pump inhibitors (PPIs) tend to be more effective than H2 blockers. Comparisons between PPI types or dosages showed few consistent differences. The most common side effects cited for PPIs and H2 blockers were diarrhea, headache, and abdominal pain.
The AHRQ report concluded that a type of surgical treatment known as laparoscopic fundoplication is at least as effective as drug-based medical treatment for some patients, but also had a higher risk of serious side effects. The report also found that fundoplication surgery decreased, but did not always eliminate, the use of antireflux medications. The surgical treatment using an endoscopic variation of fundoplication also has been used to treat GERD, but AHRQ’s analysis found there is not enough evidence to compare this type of surgery’s effectiveness with other treatments.
The new publication – a summary for consumers and a companion publication for clinicians – is based on the findings of a comprehensive report updated for AHRQ’s Effective Health Care Program by the Tufts Medical Center Evidence-based Practice Center.
The report, and consumer and clinician publications are available at www.effectivehealthcare.ahrq.gov.
The 2011 GERD report is an update to a 2005 report. The systematic review of 166 clinical studies published between January 2004 and August 2010 examined the comparative effectiveness, benefits, and adverse effects of treatments for GERD and investigated whether there are factors that influence or predict treatment effectiveness. It helps provide information that doctors and patients can use when considering a plan for treatment.
The review did not evaluate diagnostic approaches, treatment options for patients with symptoms resistant to treatments, or the effect of lifestyle modifications on GERD symptoms. It does not represent clinical recommendations or guidelines.
Talk to Your Doctor
As with any chronic health disorder talk to your doctor about how your condition affects your life. Discuss your treatment goals and options. Understand treatment benefits and risks. Work in partnership with your doctor to help ensure the best results.
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Published in Digestive Health Matters, Vol. 21, No. 3.