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Open Access Highly Accessed Research article

Alternative vs. conventional treatment given on-demand for gastroesophageal reflux disease: a randomised controlled trial

Per G Farup12*, Mathis Heibert3 and Victor Høeg4

Author Affiliations

1 Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway

2 Unit for Applied Clinical Research, Norwegian University of Science and Technology, Trondheim, Norway

3 Department of Medicine, Nord-Trøndelag Hospital Trust, Namsos, Norway

4 Department of Medicine, Innlandet Hospital Trust, Tynset, Norway

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BMC Complementary and Alternative Medicine 2009, 9:3  doi:10.1186/1472-6882-9-3

Published: 24 February 2009

Abstract

Background

Alternative treatments are commonly used for various disorders and often taken on-demand. On-demand treatment of gastroesophageal reflux disease (GERD) with pharmaceutical products is an established, cost-effective strategy. Comparisons between alternative medicine and pharmaceutical products are rare. The aim of this trial was to compare on-demand treatment with a pectin-based, raft-forming, natural, anti-reflux agent (PRA) with that of esomeprazole 20 mg (Eso20) in patients with mild/moderate GERD.

Methods

Patients with mild/moderate GERD were randomised to a six weeks' on-demand treatment with PRA or Eso20 in a pragmatic, open, multicentre trial. Overall satisfaction with treatment, satisfactory relief on a weekly basis, reflux symptoms, and treatment preferences were noted.

Results

Seventy-seven patients were included in the analyses. Eso20 was significantly superior to PRA for proportion of overall satisfied patients (92% and 58% respectively; p = 0.001), reduction of symptoms (mean symptom scores at the end 5.9 and 8.0 respectively; p = 0.019), proportion of weeks of satisfactory relief (89% and 62% respectively; p = 0.008) and proportion preferring continuation with the same treatment (85% and 42% respectively; p < 0.001). Older patients were more satisfied than younger, and patients preferring on-demand treatment had lower symptom scores at inclusion than those preferring regular treatment.

Conclusion

On-demand treatment with esomeprazole 20 mg was clearly superior to the pectin-based raft-forming agent. Most patients preferred on-demand treatment to regular treatment. Those preferring regular therapy had significantly more symptoms at inclusion.

Trial registration

ClinicalTrials.gov: NCT00184522.