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Two techniques to treat heartburn are effective

January 19, 2009 |  3:30 pm

People with severe heartburn, called gastroesophageal reflux disease, usually take medications called proton pump inhibitors to control their symptoms. But the medications don't work for everyone and some people dislike staying on drug therapy for years. Surgery to repair the valve that allows stomach acid to back up into the esophagus can help resolve the symptoms, too, and researchers have been keenly interested in developing simpler techniques that would take the place of surgery.

A study published today in the Archives of Surgery compared two of the newer nonsurgical repair techniques that use the body's natural passages to navigate the esophagus. The study concludes that both are effective at reducing medication use and improving voice and swallowing symptoms. The two procedures studied were full-thickness plication, which uses an endoscope to tighten the area between the esophagus and stomach with sutures, and radio-frequency therapy, which delivers energy waves to the muscles of the esophagus and stomach to improve the function of the valve.

Dr. Louis O. Jeansonne IV, of Emory University School of Medicine, compared the two therapies in 126 patients treated between 2002 and 2006; 68 with radio-frequency therapy and 58 with full-thickness plication. Among those who had radio-frequency therapy, moderate to severe heartburn symptoms decreased from 55% to 22% and medication use decreased from 84% to 50%. Among patients who had full-thickness plication, moderate to severe heartburn symptoms decreased from 53% to 43%, and medication use decreased from 95% to 43%. For patients whose chief complaint was regurgitation, full-thickness plication may be the preferred method, the authors said.

More studies are needed to assess the long-term effect of the therapies, they noted. Information on gastroesophageal reflux disease can be found on the National Institutes of Health Medline Plus website.

-- Shari Roan

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