[Endoscopic therapy for gastroesophageal reflux disease]

A variety of endoscopic techniques for the treatment of gastroesophageal reflux disease (GERD) have been developed as alternatives to PPI therapy or antireflux surgery. These techniques include the delivery of radiofrequency energy to the gastroesophageal junction, injection of agents into the lower esophageal sphincter zone, and suture plication of the proximal fundic folds. Each of these endoscopic techniques is designed to alter the anatomy or physiology of the gastroesophageal junction to decrease gastroesophageal reflux. However, only limited data are available on the mechanism of action of the various endoscopic techniques. Most studies of endoscopic therapy have only limited follow-up information, and safety issues remain unresolved. Further sham-controlled clinical trials will be required for endoscopic device and technique.