Keyhole surgery may be better than medication for some sufferers of a condition that affects around 20% of the Western adult population.
Aberdeen researchers and clinicians led a major UK trial which examined the benefits and risks of laparoscopic fundoplication surgery as an alternative to long term medication for treating chronic gastro-oesophageal reflux disease.
In a paper just published in the British Medical Journal, the University of Aberdeen and NHS Grampian led team found that surgery was significantly better than medication for those with chronic reflux.
Sufferers of severe reflux can experience heartburn, indigestion, bloating, disrupted sleep and chest pain which impacts on their quality of life. It can also deter those afflicted from eating and drinking socially, and be a barrier to activities that include bending down, such as sport or exercise.
The £1.1M study set out to determine the relative benefits and risks of the surgery as an alternative to long term medication for severe reflux.
A total of 810 patients from 21 hospitals across the UK were recruited into the trial, which took placed between 2000 and 2005. Of these, 329 had surgery.
A high number of surgical patients were from the North East of Scotland as one of the trial team – surgeon Professor Zyg Krukowski at Aberdeen Royal Infirmary – is a pioneer of the technically difficult procedure.
He said: "The benefits of surgery over medical therapy are significant but at the cost of side effects, for example difficulty swallowing, bloating and altered bowel habit, in a small number of patients."
Professor Adrian Grant from the University of Aberdeen's Health Services Research Unit led the trial. He said: "The majority of people with chronic reflux take medication to ease their condition, but, by and large, this means having to take tablets for the rest of their lives.
"At one year, our trial showed that surgery gave a better improvement in symptoms and quality of life for patients with chronic reflux - and the more severe the symptoms, the better or greater the benefit.
"We are now carrying out further research to see if the improvements following surgery are sustained."
An accompanying commentary in the BMJ praised the trial as an "excellent model of how to design and conduct a robust and pragmatic randomised trial within the complexity of the NHS."