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Comparative Effectiveness of Management Strategies for Adults With Gastroesophageal Reflux Disease: An Update

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Conclusions

In summary, the CER of treatments for GERD found the following: PPIs appear to be superior to H2RAs for the treatment of chronic GERD, but comparisons among different PPIs or among different dosages and dosing regimens of PPIs show few consistent differences. Limited studies suggest that continuous daily dosing provides improved symptom control and quality of life at 6 months when compared to on-demand dosing. Through up to 3 years of followup, surgery is as effective as medication, but serious adverse effects may be more common with surgical treatments. Evidence to evaluate endoscopic treatments is lacking. Medication, surgery, and endoscopic treatments all have associated adverse effects, some of them serious.

Abbreviations:
CER = comparative effectiveness review
GERD = gastroesophageal reflux disease
H2RA = histamine type 2 receptor antagonist
PPI = proton pump inhibitor