Traditional Nonsurgical GERD Treatments Not Impressive

Jan. 24 -- FRIDAY, Jan. 23 (HealthDay News) -- Two traditional nonsurgical methods for correcting the anatomical flaw responsible for gastroesophageal reflux disease (GERD) produce only fair to middling results, a new study shows.

Experts also noted that newer procedures have essentially taken the place of the techniques examined in the study.

GERD is a condition in which acid from the stomach backs up into the esophagus, because the valve separating the two is faulty. Its problems include heartburn, voice symptoms and cough. It can be treated by medications such as proton pump inhibitors, which reduce acid levels, but best results require surgery to repair the valve.

But surgery has its own problems, so nonsurgical methods of treating GERD have long been used. A new report in the January issue of the Archives of Surgery described how the two methods were put to the test in a study of 124 people treated at Emory University in Atlanta.

Of these, 68 underwent radiofrequency therapy, in which a beam of energy waves is aimed at the muscles of the esophagus and stomach to improve the function of the valve. The others had full-thickness plication, in which a long, narrow tube called an endoscope carries in instruments to suture the junction between the stomach and the esophagus.

In an average follow-up of six months, the incidence of moderate to severe heartburn decreased from 55 percent to 22 percent among those undergoing radiofrequency therapy. Use of GERD drugs decreased from 84 percent to 50 percent, and there were fewer reports of swallowing difficulties, voice symptoms and cough.

In the full-thickness plication group, moderate to severe heartburn decreased from 53 percent to 43 percent. Medication use decreased from 95 percent to 43 percent, and decreases were reported for voice symptoms and swallowing difficulties.

However, it is an underwhelming report, said Dr. Anthony A. Starpoli, a gastroenterologist at Lenox Hill Hospital in New York City, not only because better results were hoped for, but also because both methods are considered obsolete.