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Endoscopic techniques for treating gastroesophageal reflux

Reyes Genere, Juan; Wang, Kenneth K.

Current Opinion in Gastroenterology: September 2018 - Volume 34 - Issue 5 - p 288–294
doi: 10.1097/MOG.0000000000000468
ENDOSCOPY: Edited by Anthony N. Kalloo

Purpose of review Nearly, a third of patients with medically refractory gastroesophageal reflux disease (GERD) will desire an additional nonsurgical treatment option. Recently, endoscopic therapy has been reintroduced as a minimally invasive antireflux barrier treatment, after addressing prior efficacy and safety concerns. Over the last two decades, additional experience and new technologies have resulted in devices and protocols with favorable short-term outcomes and safety profiles. The current literature in endoscopic antireflux therapies covers new devices, long-term follow-up data and further safety experience. This review discusses the endoscopic antireflux devices on the market and most recent studies in this area.

Recent findings Quality of life and reflux symptom score improvement is observed in 73–90% of patients through a 36–48 month follow-up period, with 41–77% remaining off all reflux medicines. Composite data from several thousand cases indicate a low rate (0.93–2.4%) of serious complications and no late adverse effects, including gas-bloat syndrome.

Summary In this review, we describe the four endoscopic antireflux devices on market and summarize the current data in the literature. The short and long-term data demonstrate durable symptom improvement and favorable safety profile. Endoscopic antireflux treatment should be considered in the management of GERD.

Mayo Clinic, Rochester, Minnesota, USA

Correspondence to Kenneth K. Wang, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Tel: +1 507 773 7911; e-mail: Wang.Kenneth@mayo.edu

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