Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn.

  title={Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn.},
  author={Stuart Jon Spechler and John G. Hunter and Karen M. Jones and Robert H. Lee and Brian R. Smith and Hiroshi Mashimo and Vivian M. Sanchez and Kerry B. Dunbar and Thai Ha Pham and Uma K. Murthy and Taewan Kim and Christian S. Jackson and Jason M. Wallen and Erik C von Rosenvinge and Jonathan P. Pearl and Loren Laine and Anthony W. Kim and Andrew M. Kaz and Roger P Tatum and Ziad Gellad and Sandhya A. Lagoo-Deenadayalan and Joel H. Rubenstein and Amir A. Ghaferi and Wai-Kit Lo and Ronald S. Fernando and Bobby S. Chan and Shirley C. Paski and Dawn Provenzale and Donald O. Castell and David A. Lieberman and Rhonda F. Souza and William D. Chey and Stuart R. Warren and Anne Davis-Karim and Shelby D. Melton and Robert M. Genta and Tracey Serpi and Kousick Biswas and Grant D. Huang},
  journal={The New England journal of medicine},
  volume={381 16},
BACKGROUND Heartburn that persists despite proton-pump inhibitor (PPI) treatment is a frequent clinical problem with multiple potential causes. Treatments for PPI-refractory heartburn are of unproven efficacy and focus on controlling gastroesophageal reflux with reflux-reducing medication (e.g., baclofen) or antireflux surgery or on dampening visceral hypersensitivity with neuromodulators (e.g., desipramine). METHODS Patients who were referred to Veterans Affairs (VA) gastroenterology clinics… 

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