Endoscopic Management of Gastroesophageal Reflux Disease: Revisited
Gastroesophageal reflux disease (GERD) is defined by the presence of troublesome symptoms resulting from the reflux of gastric contents. The prevalence of GERD is increasing globally. An incompetent lower esophageal sphincter underlies the pathogenesis of GERD. Proton pump inhibitors (PPIs) form the...
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Korean Society of Gastrointestinal Endoscopy
2016
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066398/ |
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pubmed-50663982016-10-26 Endoscopic Management of Gastroesophageal Reflux Disease: Revisited Nabi, Zaheer Reddy, D. Nageshwar Review Gastroesophageal reflux disease (GERD) is defined by the presence of troublesome symptoms resulting from the reflux of gastric contents. The prevalence of GERD is increasing globally. An incompetent lower esophageal sphincter underlies the pathogenesis of GERD. Proton pump inhibitors (PPIs) form the core of GERD management. However, a substantial number of patients do not respond well to PPIs. The next option is anti-reflux surgery, which is efficacious, but it has its own limitations, such as gas bloating, inability to belch or vomit, and dysphagia. Laparoscopic placement of magnetic augmentation device is emerging as a useful alternative to conventional anti-reflux surgery. However, invasiveness of a surgical procedure remains a concern for the patients. The proportion of PPI non-responders or partial responders who do not wish for anti-reflux surgery defines the ‘treatment gap’ and needs to be addressed. The last decade has witnessed the fall and rise of many endoscopic devices for GERD. Major endoscopic strategies include radiofrequency ablation and endoscopic fundoplication devices. Current endoscopic devices score high on subjective improvement, but have been unimpressive in objective improvement like esophageal acid exposure. In this review, we discuss the current endoscopic anti-reflux therapies and available evidence for their role in the management of GERD. Korean Society of Gastrointestinal Endoscopy 2016-09 2016-09-30 /pmc/articles/PMC5066398/ /pubmed/27744659 http://dx.doi.org/10.5946/ce.2016.133 Text en Copyright © 2016 Korean Society of Gastrointestinal Endoscopy This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Nabi, Zaheer Reddy, D. Nageshwar |
| spellingShingle |
Nabi, Zaheer Reddy, D. Nageshwar Endoscopic Management of Gastroesophageal Reflux Disease: Revisited |
| author_facet |
Nabi, Zaheer Reddy, D. Nageshwar |
| author_sort |
Nabi, Zaheer |
| title |
Endoscopic Management of Gastroesophageal Reflux Disease: Revisited |
| title_short |
Endoscopic Management of Gastroesophageal Reflux Disease: Revisited |
| title_full |
Endoscopic Management of Gastroesophageal Reflux Disease: Revisited |
| title_fullStr |
Endoscopic Management of Gastroesophageal Reflux Disease: Revisited |
| title_full_unstemmed |
Endoscopic Management of Gastroesophageal Reflux Disease: Revisited |
| title_sort |
endoscopic management of gastroesophageal reflux disease: revisited |
| description |
Gastroesophageal reflux disease (GERD) is defined by the presence of troublesome symptoms resulting from the reflux of gastric contents. The prevalence of GERD is increasing globally. An incompetent lower esophageal sphincter underlies the pathogenesis of GERD. Proton pump inhibitors (PPIs) form the core of GERD management. However, a substantial number of patients do not respond well to PPIs. The next option is anti-reflux surgery, which is efficacious, but it has its own limitations, such as gas bloating, inability to belch or vomit, and dysphagia. Laparoscopic placement of magnetic augmentation device is emerging as a useful alternative to conventional anti-reflux surgery. However, invasiveness of a surgical procedure remains a concern for the patients. The proportion of PPI non-responders or partial responders who do not wish for anti-reflux surgery defines the ‘treatment gap’ and needs to be addressed. The last decade has witnessed the fall and rise of many endoscopic devices for GERD. Major endoscopic strategies include radiofrequency ablation and endoscopic fundoplication devices. Current endoscopic devices score high on subjective improvement, but have been unimpressive in objective improvement like esophageal acid exposure. In this review, we discuss the current endoscopic anti-reflux therapies and available evidence for their role in the management of GERD. |
| publisher |
Korean Society of Gastrointestinal Endoscopy |
| publishDate |
2016 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066398/ |
| _version_ |
1613686235991113728 |