Long-term Antireflux Medication Use Following Pediatric Nissen Fundoplication

HYPOTHESIS: Nissen fundoplication decreases the use of antireflux medications. DESIGN: Retrospective cohort study using discharge abstract data and pharmacy data. SETTING: Twelve regional Kaiser Permanente hospitals in southern California. PATIENTS: Three hundred forty-two patients underwent Nissen fundoplication. INTERVENTION: Nissen fundoplication. MAIN OUTCOME MEASURE: Use of antireflux medications. RESULTS: The number of patients requiring antireflux medications decreased from 233 patients (68.1%) before Nissen fundoplication to 197 (57.6%) after Nissen fundoplication. Of the 233 patients, 176 (75.6%) were restarted on antireflux medications within 1 year after Nissen fundoplication. Use of antireflux medication decreased in neurologically healthy patients but was unchanged in neurologically impaired children. CONCLUSIONS: Use of antireflux medication decreased after Nissen fundoplication. Neurologically healthy children showed the biggest decrease in antireflux medication use after Nissen fundoplication.