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Management of refractory heartburn: are we convinced that surgery is better than medical treatment?

Md Jalil, Muhammad Ateeq and Wong, Zhiqin and Raja Ali, Raja Affendi and Lee, Yeong Yeh (2020) Management of refractory heartburn: are we convinced that surgery is better than medical treatment? Journal of the Royal College of Physicians of Edinburgh, 50 (1). pp. 51-53. ISSN 1478-2715

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In a nutshell, this was a single centre, randomised-controlled trial comparing surgical vs medical modality in treating protonpump inhibitor (PPI)-refractory heartburn; a common condition where optimal treatment approach is not known. All patients referred to the Veterans Affairs gastroenterology clinics for refractory heartburn were screened. Eligible patients would complete the gastro-oesophageal refl ux disease (GORD) – Health Related Quality of Life (GORD-HRQL) questionnaire followed by 2-week trial of omeprazole at a dose of 20 mg twice daily, after which the GORD-HRQL was repeated. Patients who did not show improvement (i.e. decrease of >50% in the initial GORD-HRQL score) then underwent endoscopy with biopsies from the lower oesophagus, but also oesophageal manometry and intraluminal impedance– pH monitoring while continuing omeprazole at the same dose and frequency. Patients with severe refl ux oesophagitis, nonGORD endoscopic abnormalities, oeosinophilic oesophagitis, achalasia or absent contractility were excluded. Other patientreported outcomes included depression, anxiety and health function.

Item Type: Article (Journal)
Additional Information: 7911/82678
Uncontrolled Keywords: baclofen, desipramine, dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, placebo, rabeprazol
Subjects: R Medicine > R Medicine (General)
R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine
Depositing User: Dr Muhammad Ateeq Md Jalil
Date Deposited: 07 Sep 2020 09:59
Last Modified: 07 Sep 2020 09:59
URI: http://irep.iium.edu.my/id/eprint/82678

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