Use of acid-suppressive therapy before anti-reflux surgery in 2922 patients: a nationwide register-based study in Denmark

Aliment Pharmacol Ther. 2015 Jul;42(1):84-90. doi: 10.1111/apt.13230. Epub 2015 May 5.


Background: Guidelines recommend that patients with gastro-oesophageal reflux disease are adequately treated with acid-suppressive therapy before undergoing anti-reflux surgery. Little is known of the use of acid-suppressive drugs before anti-reflux surgery.

Aim: To determine the use of proton pump inhibitors and H2 -receptor antagonists in the year before anti-reflux surgery.

Methods: A nationwide retrospective study of all patients aged ≥18 undergoing first-time anti-reflux surgery in Denmark during 2000-2012 using data from three different sources: the Danish National Register of Patients, the Danish National Prescription Register, and the Danish Person Register.

Results: The study population thus included 2922 patients (median age: 48 years, 55.7% male). The annual proportion of patients redeeming ≥180 DDD of acid-suppressive therapy increased from 17.0% 5 years before anti-reflux surgery to 64.9% 1 year before. The probability for inadequate dosing 1 year before surgery (<180 DDD) was significantly increased for younger patients, patients operated in the period 2000-2003, patients who had not undergone pre-surgical manometry, pH- or impedance monitoring, and patients who had not redeemed prescriptions on NSAID or anti-platelet drugs.

Conclusion: Compliance with medical therapy should be evaluated thoroughly before planning anti-reflux surgery, as a high proportion of patients receive inadequate dosing of acid-suppressive therapy prior to the operation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Denmark
  • Electric Impedance
  • Female
  • Gastroesophageal Reflux / drug therapy*
  • Gastroesophageal Reflux / surgery
  • Histamine H2 Antagonists / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use*
  • Retrospective Studies


  • Histamine H2 Antagonists
  • Proton Pump Inhibitors