Gastro-oesophageal reflux. Part 3: medical and surgical treatment.

INTRODUCTION AND

BACKGROUND

Gastro-oesophageal reflux disease (GORD) is a recurrent, long-term gastrointestinal condition characterised by the abnormal reflux of stomach contents into the oesophagus. Heartburn is the most dominant symptom, which can be life long and can considerably reduce quality of life. The main goals of treatment are to alleviate symptoms and prevent relapses, oesophageal stricture and adenocarcinoma. This paper presents a review comparing the effectiveness of omeprazole with Nissen fundoplication surgery for the treatment of GORD.

METHODS

A search for English-language studies on adults was conducted using three databases-MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL). Thirteen studies were included in the review.

FINDINGS: Nissen fundoplication is more effective in controlling heartburn symptoms, healing oesophagitis and preventing relapses than omeprazole. Quality of life, in terms of productivity and ability to work, is difficult to assess in the omeprazole group and, as a result, a comparison of this aspect is limited. Although fundoplication is expensive in the short term, it is more cost-effective than omeprazole after 8 years.

CONCLUSIONS

Nurses need to be aware of the effectiveness of omeprazole and fundoplication to provide patients with accurate information, which assists patients in decision making regarding treatment options.