BACKGROUND: This randomized clinical trial compared long-term outcome after antireflux surgery with acid inhibition therapy in the treatment of chronic @entity354 ( @entity354 ). METHODS: @entity1 with chronic @entity354 and @entity354 verified at endoscopy were allocated to treatment with @entity4546 (154 patients) or antireflux surgery (144). After 7 years of follow-up, 119 @entity1 in the @entity4546 arm and 99 who had antireflux surgery were available for evaluation. The primary outcome variable was the cumulative proportion of @entity1 in whom treatment failed. Secondary objectives were evaluation of the treatment failure rate after dose adjustment of @entity4546 , safety, and the frequency and severity of post-fundoplication complaints. RESULTS: The proportion of @entity1 in whom treatment did not fail during the 7 years was significantly higher in the surgical than in the medical group (66.7 versus 46.7 per cent respectively; P=0.002). A smaller difference remained after dose adjustment in the @entity4546 group (P=0.045). More @entity1 in the surgical group complained of symptoms such as @entity1282 , @entity391 , and rectal flatulence. These complaints were fairly stable throughout the study interval. The mean daily dose of @entity4546 was 22.8, 24.1, 24.3 and 24.3 mg at 1, 3, 5 and 7 years respectively. CONCLUSION: Chronic @entity354 can be treated effectively by either antireflux surgery or @entity4546 therapy. After 7 years, surgery was more effective in controlling overall disease symptoms, but specific post-fundoplication complaints remained a problem. There appeared to be no dose escalation of @entity4546 with time.

Seven-year follow-up of a randomized clinical trial comparing proton-pump inhibition with surgical therapy for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity391 :: ('MESH:D014839', 'Disease') :: ['inability to belch or vomit'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia'] @entity354 :: ('MESH:D005764', 'Disease') :: ['gastro-oesophageal reflux disease', 'GORD', 'oesophagitis'] @entity4546 :: ('MESH:D009853', 'Chemical') :: ['omeprazole']
@entity354 :: (MESH:D005764,Disease) :: ['reflux oesophagitis']
