Gastric patients do worse with surgery

Doctors who advise patients with gastroesophageal reflux disease (GERD) to undergo surgery may be misleading them to think that it may reduce subsequent drug use and cancer risk.

A recent study conducted to determine the outcome of surgery versus drug use in GERD found that nearly two thirds of patients who underwent an antireflux surgical procedure still required antireflux medications afterwards. The researchers also found that 92 per cent of medical patients and 62 per cent of surgical patients used antireflux medications on a regular basis.

Worse, the 10 year survival rate among those who had surgery was significantly lower, with more deaths due to heart disease.

The authors observed that the idea that surgery may prevent cancer is somewhat misleading as the mortality rate due to oesophageal cancer with or without surgery is similar and very low. With only two deaths because of oesophageal cancer in the study, the researchers suggest that the risk of cancer development with GERD seems to be very much exaggerated (J Am Med Assoc, 2001: 285: 2331-8).

A related small study has found that simply chewing gum can ease the symptoms of GERD. Eating increases gastroesophageal acid levels, leading to uncomfortable symptoms, but chewing gum for one hour after a meal had a sustained benefit, more so than walking or sitting still (Aliment Pharmacol Ther, 2001; 15: 151-5).