Endoscopic treatment of gastroesophageal reflux disease

GERD is a common GI disorder. In fact, it is the fourth most prevalent GI disease in the United States. More than one fourth of adults in the United States use antisecretory medications at least 3 times per month, resulting in a large economic burden. It has been estimated that almost $2 billion is spent in the United States each year on OTC antacids and histamine-2 receptor antagonists, and another $10 billion is spent on prescription histamine-2 receptor antagonists and PPIs. Current methods for the pharmacological treatment of GERD include antacids, promotility agents, histamine receptor blockers, and PPIs. Surgical barrier methods (Nissen fundoplication) are most often performed laparoscopically. Lifestyle changes may help to diminish some of the symptoms associated with GERD. Although medical therapy has been shown to be effective, the inconvenience and cost of long-term drug therapy has led to the consideration of alternative methods of treatment. Surgical therapy has its drawbacks, in that many patients may require continued medical therapy after surgery and the fundoplication may eventually breakdown.