Back to Program | 2010 Program and Abstracts Overview | 2010 Posters

Objective: In patients with GERD who were stable and symptomatically controlled on long-term medical therapy we performed an RCT to compare ongoing optimized medical therapy with LNF for the control of chronic GERD symptoms including cough.Methods: 201 patients were eligible for randomization, 104 gave informed consent (age: mean 42.9, SD 11, male 55 female 49) and 2 withdrew from the study immediately after randomization. Patients randomized to medical therapy received optimized treatment with PPI using a standardized management protocol and surgical patients LNF. Patients underwent symptom evaluation using the GERD symptom score (GSS), a published and validated instrument that includes cough. Individual cough scores varied from a low of 0 for no cough to a maximum of 12. Medical patients were evaluated on PPI, surgical patients off PPI. Results: 49 (47%) of the 104 patients (24M, 25F) complained of cough at the time of randomization and the follow up cough scores (mean, 95% CI) in these 49 patients are shown 12 and 36 months after randomization (figure). There were no significant differences between medically and surgically treated patients at any evaluation point. Both groups showed significant and clinically important improvement in cough scores.Conclusions: In patients whose GERD symptoms are stable and controlled on PPI, surgery provides equal long-term control of cough for those who do not wish to remain on long-term PPI therapy.