Endoscopic Management of Reflux

Phuong Nguyen; Jennifer Phan; Kenneth J Chang

doi:10.1016/j.giec.2025.02.003

Endoscopic Management of Reflux

Gastrointest Endosc Clin N Am. 2025 Jul;35(3):603-621. doi: 10.1016/j.giec.2025.02.003. Epub 2025 Apr 1.

Authors

Phuong Nguyen¹, Jennifer Phan¹, Kenneth J Chang²

Affiliations

¹ Division of Gastroenterology and Hepatology, Digestive Health Institute, Hoag Memorial Hospital Presbyterian, Hoag Health, 500 Superior Avenue, Newport Beach, CA 92663, USA.
² Division of Gastroenterology and Hepatology, Digestive Health Institute, Hoag Memorial Hospital Presbyterian, Hoag Health, 500 Superior Avenue, Newport Beach, CA 92663, USA. Electronic address: Ken.chang@hoag.org.

PMID: 40412993
DOI: 10.1016/j.giec.2025.02.003

Abstract

The pathophysiology of gastroesophageal reflux disease (GERD) is complex and involves the integration of both the lower esophageal sphincter complex and the diaphragm crura. While medical and surgical treatments have been the mainstay of GERD therapy, several endoscopic treatment approaches are currently used in clinical practice. The most common endoscopic approaches to manage GERD include transoral incisionless fundoplication; endoscopic suturing; and endoscopic resection or ablation, alone or in combination with suturing. In this article, these endoscopic antireflux procedures will be reviewed, with special emphasis on the proposed mechanism of action, patient selection, clinical outcomes, safety, and technical considerations.

Keywords: Esophagitis; Fundoplication; Gastroesophageal reflux; Hiatal hernia; Humans; Laparoscopy; Proton pump inhibitors.

Publication types

Review

MeSH terms

Endoscopy, Gastrointestinal* / methods
Esophageal Sphincter, Lower / surgery
Esophagoscopy* / methods
Fundoplication* / methods
Gastroesophageal Reflux* / physiopathology
Gastroesophageal Reflux* / surgery
Humans
Patient Selection
Suture Techniques