ORIGINAL CONTRIBUTION Long-term Outcome of Medical and Surgical Therapies for Gastroesophageal Reflux Disease Follow-up of a Randomized Controlled Trial

GASTROESOPHAGEAL REFLUXdisease (GERD) is one of themost common chronic dis-orders of the gastrointesti-nal tract.1,2 Surveys have shown that approximately 20 % of US adults expe-rience GERD symptoms such as heart-burn and acid regurgitation at least once per week.3,4 GERD and its sequela, Bar-rett esophagus, are strong risk factors for esophageal adenocarcinoma,5,6 a ma-lignancy that has nearly quadrupled in frequency during the past 2 decades.7 Medical treatment of GERD involves long-term administration of antacids and antisecretory agents,8 and pa-tients in the United States may spend as much as an estimated $5 billion an-nually on antireflux medicines.9 Anti-Author Affiliations are listed at the end of this article