title: Alternative vs. conventional treatment given on-demand for gastroesophageal reflux disease: a randomised controlled trial.
abstract: BACKGROUND
  Alternative treatments are commonly used for various disorders and often taken on-demand. On-demand treatment of gastroesophageal reflux disease (GERD) with pharmaceutical products is an established, cost-effective strategy. Comparisons between alternative medicine and pharmaceutical products are rare. The aim of this trial was to compare on-demand treatment with a pectin-based, raft-forming, natural, anti-reflux agent (PRA) with that of esomeprazole 20 mg (Eso20) in patients with mild/moderate GERD.
  
  
  METHODS
  Patients with mild/moderate GERD were randomised to a six weeks' on-demand treatment with PRA or Eso20 in a pragmatic, open, multicentre trial. Overall satisfaction with treatment, satisfactory relief on a weekly basis, reflux symptoms, and treatment preferences were noted.
  
  
  RESULTS
  Seventy-seven patients were included in the analyses. Eso20 was significantly superior to PRA for proportion of overall satisfied patients (92% and 58% respectively; p = 0.001), reduction of symptoms (mean symptom scores at the end 5.9 and 8.0 respectively; p = 0.019), proportion of weeks of satisfactory relief (89% and 62% respectively; p = 0.008) and proportion preferring continuation with the same treatment (85% and 42% respectively; p < 0.001). Older patients were more satisfied than younger, and patients preferring on-demand treatment had lower symptom scores at inclusion than those preferring regular treatment.
  
  
  CONCLUSIONS
  On-demand treatment with esomeprazole 20 mg was clearly superior to the pectin-based raft-forming agent. Most patients preferred on-demand treatment to regular treatment. Those preferring regular therapy had significantly more symptoms at inclusion.
authors.affiliation: Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway. per.farup@ntnu.no
authors.forename: Per G
authors.initials: PG
authors.lastname: Farup
authors.forename: Mathis
authors.initials: M
authors.lastname: Heibert
authors.forename: Victor
authors.initials: V
authors.lastname: Høeg
mesh_terms: D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001639:Bicarbonates / Q000627:therapeutic use*; D000529:Complementary Therapies / Q000009:adverse effects; D064098:Esomeprazole / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010368:Pectins / Q000627:therapeutic use*; D017680:Potassium Compounds / Q000627:therapeutic use*
chemical_list: D000897:Anti-Ulcer Agents; D001639:Bicarbonates; D017680:Potassium Compounds; C005479:magnesium carbonate; D010368:Pectins; C026329:potassium bicarbonate; D008274:Magnesium; D064098:Esomeprazole