Table 2: Potential advantages and disadvantages of medical therapy and antireflux surgery in the management of chronic gastroesophageal reflux disease [104].

Medical

Advantages
 (i) Noninvasive
 (ii) Simple and easy to use
 (iii) Reproducible effect
 (iv) Very effective on symptoms and lesions of GERD
 (v) Excellent tolerance and safety profile of PPI
 (vi) Relatively cheap especially since the development of PPI generics
Disadvantages
 (i) Does not correct underlying pathophysiological mechanisms
 (ii) Continuous maintenance therapy frequently required to control the disease
 (iii) Persistence of symptoms in at least 10% of patients
 (iv) Rare side effects and potential drug-drug interactions

Surgery

Advantages
 (i) The only treatment capable of physically controlling reflux
 (ii) Very effective (improved quality of heartburn control, reduction of regurgitation, better sleep pattern, increased activities and
 exercise, etc.)
 (iii) Avoids the need to take medication
 (iv) Psychological effects of not having chronic disease
 (v) Particular clinical groups of cystic fibrosis, lung transplant, and congenital hernia
Disadvantages
 (i) Invasive
 (ii) Small risk of mortality
 (iii) Measurable postoperative mortality
 (iv) Recurrence is possible