# Endoscopic Therapies for GERD: Are We Ready for Prime Time?



## Jeffrey Roberts (Apr 15, 1987)

http://www.medscape.com/viewarticle/434529 Endoscopic Therapies for GERD: Are We Ready for Prime Time?M. Brian Fennerty, MDIntroduction and Background Gastroesophageal reflux disease (GERD) affects at least 20% of the US population; this prevalence is likely an underestimate, as it only includes those with the classical symptoms of heartburn and regurgitation and does not take into account the many patients with GERD-induced cough, hoarseness, asthma, noncardiac chest pain, etc. GERD has also been demonstrated to have a significant impact on quality of life, similar to that seen in patients with diabetes, hypertension, and many other commonly encountered diseases. Thus, GERD has enormous clinical and economic implications for the practicing physician.The goals of therapy in the patient with GERD are primarily to relieve GERD symptoms and, by doing so, heal esophagitis (if present), prevent complications, and minimize further use of healthcare resources. Medical therapy of GERD and its clinical manifestations has primarily focused on the reduction and elimination of acid refluxate and has included lifestyle modifications (which are of minimal clinical benefit) and pharmacologic therapy (using antisecretory therapy with either histamine-2 receptor antagonists [H2RAs], or proton-pump inhibitors [PPIs]). There has been some speculation that elimination of other components of refluxate (bile acids, pepsin, etc.) is potentially a better therapeutic approach. Elimination of these other components of refluxate can only be achieved with the creation of a barrier between the stomach and esophagus and has previously required a surgical antireflux procedure. Most recently, endoscopic therapies for GERD have been developed that also serve to form a barrier to reflux. At this year's Digestive Disease Week meeting, numerous papers were presented in the field of endoscopic therapy for GERD. This review summarizes these research reports and is accompanied by personal commentary regarding their impact on the future of therapy for GERD.Copyright ï¿½ 1994-2002 by Medscape


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