The study was published in Wednesday's Journal of the American Medical Association. The earlier research, based on patients followed for two years, also suggested that surgery might alleviate the need for antacids or other medication. Dr. Peter Kahrilas of Northwestern University wrote in an accompanying editorial. Spechler said surgery might still be advised for patients who cannot tolerate medication, offering the possibility of at least a few years' relief. GERD is caused by a faulty valve that allows stomach contents to back up and cause heartburn.
Sufferers run an increased risk of esophageal cancer, presumably because of the constant irritation.
Medication is the most common treatment. About 35,000 such operations are done annually, but they involve the same procedure as the more invasive surgery Spechler's patients underwent - creating a new valve by wrapping part of the stomach around the end of the esophagus. The researchers suggest that laparacopies could have yielded the same results. The new research involved 37 reflux patients operated on in the late 1980s and 90 treated with drugs alone. Medication included proton pump inhibitors, prescription drugs that stop the stomach from making acid.