Endoscopic anti-reflux therapies

Gastroesophageal reflux disease (GERD) is a very common gastrointestinal disorder worldwide. Lifestyle interventions and medical therapy remain the first-line treatment for GERD, while surgical interventions are considered the gold standard for patients who are refractory to or who prefer alternatives to medical therapy. Endoscopic anti-reflux therapies have emerged to address the treatment gap between medical management and surgical intervention. In this review, the most prominent endoscopic techniques are discussed. Transoral incisionless fundoplication has the most robust data with respect to both short- and long-term clinical efficacy. Emerging techniques, including anti-reflux mucosectomy, resection and plication, and ablation procedures, have shown promise; however, further research is required to refine these techniques, determine the durability of symptom relief, and optimize patient selection.