Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn
Spechler SJ, Hunter JG, Jones KM, Lee R, Smith BR, Mashimo H, Sanchez VM, Dunbar KB, Pham TH, Murthy UK, Kim T, Jackson CS, Wallen JM, von Rosenvinge EC, Pearl JP, Laine L, Kim AW, Kaz AM, Tatum RP, Gellad ZF, Lagoo-Deenadayalan S, Rubenstein JH, Ghaferi AA, Lo WK, Fernando RS, Chan BS, Paski SC, Provenzale D, Castell DO, Lieberman D, Souza RF, Chey WD, Warren SR, Davis-Karim A, Melton SD, Genta RM, Serpi T, Biswas K, Huang GD. Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn. New England Journal Of Medicine 2019, 381: 1513-1523. PMID: 31618539, DOI: 10.1056/nejmoa1811424.Peer-Reviewed Original ResearchConceptsPPI-refractory heartburnActive medical treatmentMedical treatmentTreatment successGastroenterology clinicSurgical treatmentProton pump inhibitor treatmentMultichannel intraluminal impedance-pH monitoringMedical groupGastroesophageal reflux diseaseFrequent clinical problemMinority of patientsHealth Related QualityImpedance-pH monitoringMultiple potential causesFunctional heartburnRefractory heartburnVisceral hypersensitivityAntireflux surgeryGastroesophageal refluxReflux diseaseUnderwent endoscopyEsophageal manometryPrimary outcomeEsophageal biopsies