[Long-term drug therapy versus antireflux surgery in chronic reflux].
In endoscopy-negative reflux disease just 25% remain in remission after drug therapy, in reflux oesophagitis only 10%. Long-term management is therefore mandatory in this quality of life-impairing chronic disorder. Following the GENVAL consensus conference proton pump inhibitors (PPI) should be used primarily in a step-down regimen; isomeric PPIs reduce duration of acute therapy by 50%. According to Klinkenberg-Knol et al. 100% of all patients with H2-resistant reflux oesophagitis are asymptomatic and free of recurrency when dosage of PPI is adapted to a higher level. The same result was obtained in the prospective study by Lundell et al. comparing fundoplication and long-term management with omeprazole for 3 years.
Rösch
W
W
Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt/M.
D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000601:surgery; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008134:Long-Term Care; D054328:Proton Pump Inhibitors; D011788:Quality of Life; D012008:Recurrence; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors