Literature Review

Gastro-oesophageal reflux. Part 3: medical and surgical treatment

Abstract

Introduction and background: Gastro-oesophageal reflux disease (GORD) is a recurrent, long-term gastrointestinal condition characterised by the abnormal reflux of stomach contents into the oesophagus. Heartburn is the most dominant symptom, which can be life long and can considerably reduce quality of life. The main goals of treatment are to alleviate symptoms and prevent relapses, oesophageal stricture and adenocarcinoma. This paper presents a review comparing the effectiveness of omeprazole with Nissen fundoplication surgery for the treatment of GORD. Methods: A search for English-language studies on adults was conducted using three databases—MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL). Thirteen studies were included in the review. Findings: Nissen fundoplication is more effective in controlling heartburn symptoms, healing oesophagitis and preventing relapses than omeprazole. Quality of life, in terms of productivity and ability to work, is difficult to assess in the omeprazole group and, as a result, a comparison of this aspect is limited. Although fundoplication is expensive in the short term, it is more cost-effective than omeprazole after 8 years. Conclusions: Nurses need to be aware of the effectiveness of omeprazole and fundoplication to provide patients with accurate information, which assists patients in decision making regarding treatment options.

References

Al Talalwah N, Woodward S (2013a) Gastro-oesophageal reflux. Part 1: smoking and alcohol reduction. Br J Nurs 22(3): 140–146 Link, Google Scholar
Al Talalwah N, Woodward S (2013b) Gastro-oesophageal reflux. Part 2: medical treatment. Br J Nurs 22(3): 277–284 Link, Google Scholar
Ali T, Roberts DN, Tierney WM (2009) Long-term safety concerns with proton pump inhibitors. Am J Med 122(10): 896–903 Crossref, Medline, Google Scholar
Allgood PC, Bachmann M (2000) Medical or surgical treatment for chronic gastrooesophageal reflux? A systematic review of published evidence of effectiveness. Eur J Surg 166(9): 713–721 Crossref, Medline, Google Scholar
Altman DG (1991) Randomisation. BMJ 302(6791): 1481–1482 Crossref, Medline, Google Scholar
Anvari M, Allen C, Borm A (1995) Laparoscopic Nissen fundoplication is a satisfactory alternative to long-term omeprazole therapy. Br J Surg 82(7): 938–942 Crossref, Medline, Google Scholar
Bain WM, Harrington JW, Thomas LE, Schaefer SD (1983) Head and neck manifestations of gastroesophageal reflux. Laryngoscope 93(2): 175–179 Crossref, Medline, Google Scholar
Bixquert M (2005) Maintenance therapy in gastro-oesophageal reflux disease. Drugs 65 (Suppl 1): 59–66 Medline, Google Scholar
Broeders JA, Draaisma WA, Rijnhart-de Jong HGet al. (2011) Impact of surgeon experience on 5–year outcome of laparoscopic Nissen fundoplication. Arch Surg 146(3): 340–346 Crossref, Medline, Google Scholar
Chiba N (1997) Proton pump inhibitors in acute healing and maintenance of erosive or worse esophagitis: a systematic overview. Can J Gastroenterol 11 (Suppl B): 66B–73B Medline, Google Scholar
Coley CM, Barry MJ, Spechler SJ,Williford W, Mulley A (1993) Initial medical vs surgical therapy for complicated or chronic reflux disease: a cost effectiveness analysis. Gastroenterology. 104: A5 Google Scholar
Cookson R, Flood C, Koo B, Mahon D, Rhodes M (2005) Short-term cost effectiveness and long-term cost analysis comparing laparoscopic Nissen fundoplication with proton-pump inhibitor maintenance for gastro-oesophageal reflux disease. Br J Surg 92(6): 700–706 Crossref, Medline, Google Scholar
Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R (1991) Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endos 1(3): 138–143 Medline, Google Scholar
Dent J, Brun J, Fendrick AM, Fennerty M, Janssens J, Kahrilas P, Lauritsen K, Reynolds J, Shaw M, Talley N. (1999) An evidence-based appraisal of reflux disease management—the Genval Workshop Report. Gut 44 Suppl 2: S1–S16 Crossref, Medline, Google Scholar
Eissele R, Arnold R (1999 Long-term management of GERD. In: Misiewicz JJ, ed, Management Issues in Gastroesophageal Reflux Disease. Life Science Communications, London: 24–33 Google Scholar
Fass R, Fennerty MB, Ofman JJ, Gralnek IM, Johnson C, Camargo E, Sampliner RE (1998) The clinical and economic value of a short course of omeprazole in patients with noncardiac chest pain. Gastroenterology 115(1): 42–49 Crossref, Medline, Google Scholar
Flynn CA (2001) The evaluation and treatment of adults with gastroesophageal reflux disease. J Fam Pract 50(1): 57–58, 61–63 Medline, Google Scholar
Galmiche J P, Letessier E, Scarpignato C (1998) Treatment of gastro-oesophageal reflux disease in adults. BMJ 316(7146): 1720–1723 Crossref, Medline, Google Scholar
Gaynor EB. (1991) Otolaryngologic manifestations of gastroesophageal reflux. Am J Gastroenterol 86(7): 801–808 Medline, Google Scholar
Gerson LB, Robbins AS, Garber A, Hornberger J, Triadafilopoulos G (2000) A cost-effectiveness analysis of prescribing strategies in the management of gastroesophageal reflux disease. Am J Gastroenterol 95(2): 395–407 Crossref, Medline, Google Scholar
Gerrish K, Lacey A, eds (2010) The Research Process in Nursing. 6th ed. Wiley-Blackwell, Oxford Google Scholar
Glise H, Wiklund I (1997) Measurement of the impact of heartburn and dyspepsia on quality of life. Aliment Pharmacol Ther 11 (S2): 73–77 Google Scholar
Gold BD, Scheiman JM, Sabesin SM, Vitat P (2007) Updates on the management of upper gastrointestinal disorders in the primary care setting: NSAID related gastropathies and pediatric reflux disease. J Fam Pract 56(3 Suppl Updates): S1–11 Medline, Google Scholar
Grant A, Wileman S, Ramsay Cet al. (2008) The effectiveness and cost-effectiveness of minimal access surgery amongst people with gastro-oesophageal reflux disease—a UK collaborative study. The REFLUX trial. Health Technol Assess 12(31):1–181, iii–iv Crossref, Medline, Google Scholar
Heidelbaugh JJ, Nostrant TT, Kim C, Van Harrison R (2003) Management of gastroesophageal reflux disease. Am Fam Physician 68(7): 1311–1318 Medline, Google Scholar
Hopkins C, Yousaf U, Pedersen M (2006) Acid reflux treatment for hoarseness. Cochrane Database Syst Rev 1: CD005054 Medline, Google Scholar
Huber R, Kohl B, Senn-Bilfinger J, Simon WA, Sturm E (1995) The continuing development of proton pump inhibitors with particular reference to pantoprazole. Aliment Pharmacol Ther 9(4): 363–378 Crossref, Medline, Google Scholar
Isolauri J, Laippala P (1995) Prevalence of symptoms suggestive of gastro-oesophageal reflux disease in an adult population. Ann Med 27(1): 67–70 Crossref, Medline, Google Scholar
Isolauri J, Luostarinen M, Viljakka M, Isolauri E, Keyriläinen O, Karvonen AL (1997) Long-term comparison of antireflux surgery versus conservative therapy for reflux esophagitis. Ann Surg 225(3): 295–299 Crossref, Medline, Google Scholar
Jobe BA, Wallace J, Hansen PD, Swanstrom LL (1997) Evaluation of laparoscopic Toupet fundoplication as a primary repair for all patients with medically resistant gastroesophageal reflux. Surgical Endosc 11(11): 1080–1083 Crossref, Medline, Google Scholar
Johanson JF (2000) Epidemiology of esophageal and supraesophageal reflux injuries. Am J Med 108 Suppl 4a: 99S–103S Crossref, Medline, Google Scholar
Klauser AG, Schindlbeck NE, Müller-Lissner SA (1990) Symptoms in gastro-oesophageal reflux disease. Lancet 335(8683): 205–208 Crossref, Medline, Google Scholar
LoBiondo-Wood G, Harber J, eds (2006) Nursing Research Methods and Critical Appraisal for Evidence-Based Practice. 6th ed. Mosby, New York Google Scholar
Lundell L, Miettinen P, Myrvold HEet al. (2001) Continued (5–year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg 192(2): 172–179 Crossref, Medline, Google Scholar
Lundell L, Miettinen P, Myrvold HEet al. (2007) Seven-year follow up of randomization clinical trial comparing proton pump inhibition with surgical therapy for reflux oesophagitis. Br J Surg 94(2): 198–203 Crossref, Medline, Google Scholar
Lundell L, Miettinen P, Myrvold HEet al. (2009) Comparison of outcomes twelve years after antireflux surgery or omeprazole maintenance therapy for reflux esophagitis. Clin Gastroenterol Hepatol 7(12): 1292–1298 Crossref, Medline, Google Scholar
Mahon D, Rhodes M, Decadt Bet al. (2005) Randomized clinical trial of laprascopic Nissen fundoplication compared with proton-pump inhibitors for treatment of chronic gastro-oesophageal reflux. Br J Surg 92(6): 695–699 Crossref, Medline, Google Scholar
Maton PN, Orlando R, Joelsson B (1999) Efficacy of omeprazole versus ranitidine for symptomatic treatment of poorly responsive acid reflux disease—a prospective, controlled trial. A liment Pharmacol Ther 13(6): 819–826 Crossref, Medline, Google Scholar
Mehta S, Bennett J, Mahon D, Rhodes M. (2006) Prospective trial of laparoscopic Nissen fundoplication vs proton pump inhibitor therapy for gastroesophageal reflux disease: seven-year follow-up. J Gastrointest Surg 10(9): 1312–1317 Crossref, Medline, Google Scholar
Moore JM, Vaezi MF (2010) Extraesophageal manifestations of gastroesophageal reflux disease: real or imagined? Curr Opin Gastroenterol 26(4): 389–394 Crossref, Medline, Google Scholar
Myrvold H E, Lundell L, Miettinen Pet al. (2001) The cost of long term therapy for gastro-oesophgeal reflux disease: a randomised trial comparing omeprazole and open antireflux surgery. Gut 49(4): 488–494 Crossref, Medline, Google Scholar
Ofman JJ, Dorn GH, Fennerty MB, Fass R (2002) The clinical and economic impact of competing management strategies for gastro-oesophageal reflux disease. Aliment Pharmacol Ther 16(2): 261–273 Crossref, Medline, Google Scholar
Parrish RS, Berube MC (1995) Care of the infant with gastroesophageal reflux and respiratory disease: after the Nissen fundoplication. J Pediatr Health Care 9(5): 211–217. Crossref, Medline, Google Scholar
Perdikis G, Hinder RA, Lund JR, Raiser F, Katada N (1997) Laparoscopic Nissen fundoplication: where do we stand? Surg Laparosc Endosc 7(1): 17–21 Crossref, Medline, Google Scholar
Richter JE (2003) Gastroesophageal reflux disease. Chapter 32. In: Yamada T, ed, Textbook of Gastroenterology. 4th ed. Lippincott, Williams and Wilkins, Philadelphia:, 1196–1224 Google Scholar
Sachs G (1997) Proton pump inhibitors and acid-related diseases. Pharmacotherapy 17(1): 22–37 Medline, Google Scholar
Shin JM, Besancon M, Simon A, Sachs G (1993) The site of action of pantoprazole in the gastric H+/K(+)–ATPase. Biochim Biophys Acta 1148(2): 223–223 Crossref, Medline, Google Scholar
Society of American Gastrointestinal and Endoscopic Surgeons (2010) Guidelines for Surgical Treatment of Gastroesophageal Reflux Disease (GERD). SAGES, Los Angeles. www.sages.org/publications/guidelines/guidelines-for-surgical-treatment-of-gastroesophageal-reflux-disease-gerd (accessed 30 March 2013) Google Scholar
Sonnenberg A (2004) Review article: anti-reflux surgery and endoluminal therapies. Aliment Pharmacol Ther 20(Suppl 5:81–88; discussion 95–96 Crossref, Medline, Google Scholar
Spechler SJ, Lee E, Ahnen Det al. (2001) Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial. JAMA 285(18): 2331–2338 Crossref, Medline, Google Scholar
Spechler SJ, Goyal RK (1986) Barrett’s esophagus. N Engl J Med 315(6): 362–371 Crossref, Medline, Google Scholar
Vakil N (2007) Review article: the role of surgery in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 25(12): 1365–1372 Crossref, Medline, Google Scholar
Vigneri S, Termini R, Leandro Get al. (1995) A comparison of five maintenance therapies for reflux esophagitis. N Engl J Med 333(17): 1106–10 (see comments) Crossref, Medline, Google Scholar
Voutilainen M, Sipponen P, Mecklin J P, Juhola M, Färkkilä M (2000) Gastroesophageal reflux disease: prevalence, clinical, endoscopic and histopathological findings in 1,128 consecutive patients referred for endoscopy due to dyspeptic and reflux symptoms. Digestion 61(1): 6–13 Crossref, Medline, Google Scholar
Wileman SM, McCann S, Grant AM, Krukowski ZH, Bruce J (2010) Medical or surgical treatment: medical versus surgical management for gastro-oesophageal reflux disease (GORD) in adults. Cochrane Database Syst Rev 3: CD003243 Medline, Google Scholar
Wise JL, Murray JA (2007) Using multichannel intraluminal impedence for diagnosing GERD: a review. Dis Esophagus 20(2): 83–88 Crossref, Medline, Google Scholar
Zagol B, Mikami D. (2011) Advances in transoral fundoplication for oesophageal reflux. Dig Liver Dis 43(5): 361–364 Crossref, Medline, Google Scholar

10 April 2013Volume 22Issue 7

ISSN (print): 0966-0461
ISSN (online): 2052-2819

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Accepted 1 January 2013

Published online 16 August 2013

Published in print 10 April 2013

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