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

Slide: 25 of 26

Knowledge Gaps and Future Research Needs

Due to a paucity of studies, the long-term comparative effectiveness of laparoscopic fundoplication versus medical treatments for the management of GERD cannot be determined. This is especially so with regard to adverse effects—the potential for lifelong PPI or H2RA treatment necessitates the study of long-term safety concerns. Most studies do not evaluate options for patients whose disease does not respond well to medications. Evidence is lacking to determine the role and value of endoscopic procedures. Evidence is sparse regarding the treatment of extraesophageal manifestations of GERD (e.g., asthma, cough, and laryngeal symptoms). Behavioral modifications to ameliorate GERD symptoms are not discussed in this report (e.g., smoking cessation, addressing anxiety, or reducing alcohol intake).

GERD = gastroesophageal reflux disease