Among study participants whose reflux-related heartburn truly did not respond to a proton-pump inhibitor (PPI), surgery (laparoscopic Nissen fundoplication) was more effective than medical therapy (omeprazole and baclofen plus desipramine if needed).
The guideline, developed by the BMJ Rapid Recommendations project, suggested no screening for individuals ages 50 to 79 years with an estimated 15-year colorectal cancer risk below 3%.
New international guideline updates recommendations on managing patients with nonvariceal GI bleeding
The new guideline is “a step forward,” particularly with regard to new endoscopic therapies and management of upper gastrointestinal (GI) bleeding in patients on antiplatelet or anticoagulant drugs, an editorial noted.
Pantoprazole did not reduce risk for a composite of upper gastrointestinal events in stable arterial disease
Given the limitations of this large industry-funded trial, the only definitive conclusion one can draw is that patients on aspirin and rivaroxaban with low risk for bleeding may get a very small benefit from long-term proton-pump inhibitor therapy, an ACP Journal Club commentary said.