Outcome of Medical versus Surgical Therapies for Gastroesophageal Reflux Disease: Meta-analysis of Randomized Controlled Trials

2010 ◽  
Vol 105 ◽  
pp. S24
Author(s):  
Abhishek Choudhary ◽  
Jessica Winn ◽  
Murtaza Arif ◽  
Nicholas Szary ◽  
Lakshmi Chauhan ◽  
...  
2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Shujie Li ◽  
Shengying Shi ◽  
Feng Chen ◽  
Jingming Lin

Objectives. Baclofen can relieve gastroesophageal reflux-related symptoms in healthy subjects and gastroesophageal reflux disease (GERD) patients by reducing the incidence of transient lower esophageal sphincter relaxation. This meta-analysis aimed to evaluate the efficacy and safety of baclofen for the treatment of GERD.Methods. We systematically searched randomized controlled trials published prior to November 2013 from PubMed, Medline, Embase, ScienceDirect, ClinicalTrials.gov, and the Cochrane Central Register of Randomized Controlled Trials. We performed a meta-analysis of all eligible trials.Results. Nine studies were identified with a total of 283 GERD patients and healthy subjects. Comparative analysis provided high quality data supporting the ability of baclofen to promote a short-term decrease in the number of reflux episodes per patient, the average length of reflux episodes, and the incidence of transient lower esophageal sphincter relaxation. No serious adverse events or death events were reported, and there were no significant differences in the overall adverse events between baclofen and placebo. All reported side effects of baclofen were of mild-to-moderate intensity, and the drug was well tolerated.Conclusion. Abundant evidence suggests that baclofen may be a useful approach for the treatment of GERD patients; however, a larger well-designed research study would further confirm this recommendation.


2005 ◽  
Vol 19 (7) ◽  
pp. 425-427 ◽  
Author(s):  
Paul Moayyedi

Gastroesophageal reflux disease (GERD) is a common problem in childhood. The cause is uncertain but because the incidence of GERD is increasing in developed countries and the prevalence of Helicobacter pylori is decreasing, it has been suggested that this infection protects against GERD. Observational data from 95 children, however, suggest that H pylori eradication does not have a deleterious effect on GERD and this is supported by randomized controlled trials in adults. H pylori eradication may also reduce the efficacy of proton pump inhibitor therapy in infected patients. There are no data from children but inferences from randomized controlled trials in adults suggest this effect is likely to be modest and of uncertain clinical significance. H pylori is an important risk factor for distal gastric adenocarcinoma. It is likely that treating the infection in childhood will prevent pre-malignant changes associated with H pylori from developing in the future. A meta-analysis of four randomized controlled trials suggest that there is a statistically significant impact on healing of chronic gastritis after one year compared with placebo (RR of chronic gastritis: 0.27; 95% CI 0.23 to 0.32). H pylori eradication is therefore recommended in children with GERD that are having an endoscopy. However, when the diagnosis of GERD is being made clinically or by pH monitoring, it is not necessary to screen for H pylori.


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