Endoscopic Management of Reflux.

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.