The Impact of Endoscopic Gastric Remodeling on Gastroesophageal Reflux Disease

Clin Transl Gastroenterol. 2025 Jun 17;16(8):e00867. doi: 10.14309/ctg.0000000000000867. eCollection 2025 Aug 1.

Abstract

Introduction: Sleeve gastrectomy is associated with an increased incidence of gastroesophageal reflux disease (GERD). By contrast, the impact of endoscopic gastric remodeling (EGR) on GERD symptoms remains unclear.

Methods: This prospective study included patients who underwent EGR and completed validated GERD-related patient-reported outcome questionnaires at baseline and 12 months postprocedure.

Results: Fifty patients were included. At 12 months post-EGR, both GERD questionnaire and Reflux Symptom Index scores significantly improved. Proton-pump inhibitor use decreased from 38% at baseline to 20% at 12 months ( P = 0.047). The presence of a hiatal hernia at baseline was associated with greater symptom improvement.

Discussion: EGR improves both typical and atypical GERD symptoms and reduces proton-pump inhibitor dependence. It may represent a preferable treatment option for patients with obesity and concomitant GERD.

Keywords: EGR; ESG; Endoscopic gastric remodeling; GERD; POSE; acid reflux; endoscopic sleeve gastroplasty.

MeSH terms

  • Adult
  • Female
  • Gastrectomy* / adverse effects
  • Gastrectomy* / methods
  • Gastroesophageal Reflux* / diagnosis
  • Gastroesophageal Reflux* / drug therapy
  • Gastroesophageal Reflux* / etiology
  • Gastroesophageal Reflux* / surgery
  • Gastroscopy* / methods
  • Hernia, Hiatal / complications
  • Hernia, Hiatal / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Prospective Studies
  • Proton Pump Inhibitors / administration & dosage
  • Proton Pump Inhibitors / therapeutic use
  • Treatment Outcome

Substances

  • Proton Pump Inhibitors