Gastroesophageal reflux disease (GERD) is a common condition that is on the rise. Obesity is one risk factor that has increased in parallel with the rise of GERD. Typical symptoms include heartburn, regurgitation, dysphagia, cough, and chest pain. Patients with typical symptoms are empirically treated with proton pump inhibitors (PPIs). If the diagnosis is not clear, further evaluation is performed with endoscopy, pH monitoring, and esophageal manometry. Untreated GERD increases the risk of esophagitis, esophageal stricture, Barrett’s esophagus, and esophageal adenocarcinoma. Treatment begins with lifestyle modification and medical therapy. If these fail, surgical and endoscopic surgical techniques are available, to provide treatment, symptom relief, and reduce long-term PPI use.
El-SeragHBSweetSWinchesterCCDentJ. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871-880. doi:10.1136/gutjnl-2012-304269
2.
RameauAMudryA. When did gastro-esophageal reflux become a disease? A historical perspective on GER(D) nomenclature. Int J Pediatr Otorhinolaryngol. 2020;137:110214. doi:10.1016/j.ijporl.2020.110214
3.
DentJEl-SeragHBWallanderMAJohanssonS. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005;54(5):710-717. doi:10.1136/gut.2004.051821
4.
SavarinoVMarabottoEZentilinPDemarzoMGde BortoliNSavarinoE. Pharmacological management of gastro-esophageal reflux disease: an update of the state-of-the-art. Drug Des Dev Ther. 2021;15:1609-1621. doi:10.2147/DDDT.S306371
5.
KatzMH. Failing the acid test: benefits of proton pump inhibitors may not justify the risks for many users. Arch Intern Med 1960. 2010;170(9):747-748. doi:10.1001/archinternmed.2010.64
MartinsenTCFossmarkRWaldumHL. The phylogeny and biological function of gastric juice-microbiological consequences of removing gastric acid. Int J Mol Sci. 2019;20(23):6031. doi:10.3390/ijms20236031
8.
KatzPODunbarKBSchnoll-SussmanFHGreerKBYadlapatiRSpechlerSJ. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27-56. doi:10.14309/ajg.0000000000001538
9.
HuntRArmstrongDKatelarisP, et al.World gastroenterology organisation global guidelines: GERD global perspective on gastroesophageal reflux disease. J Clin Gastroenterol. 2017;51(6):467-478. doi:10.1097/MCG.0000000000000854
10.
SavarinoEBredenoordAJFoxMPandolfinoJERomanSGyawaliCP. International Working Group for Disorders of Gastrointestinal Motility and Function. Expert consensus document: Advances in the physiological assessment and diagnosis of GERD. Nat Rev Gastroenterol Hepatol. 2017;14(11):665-676. doi:10.1038/nrgastro.2017.130
11.
NguyenNTThosaniNCCantoMI, et al.The American foregut society white paper on the endoscopic classification of esophagogastric junction integrity. Foregut: J Am Foregut Societ. 2022;2(4):339-348. doi:10.1177/26345161221126961
12.
Liebermann-MeffertDAllgöwerMSchmidPBlumAL. Muscular equivalent of the lower esophageal sphincter. Gastroenterology (New York, NY 1943). 1979;76(1):31-38. doi:10.1016/S0016-5085(79)80124-9
13.
DoddsWJDentJHoganWJ, et al.Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med. 1982;307(25):1547-1552. doi:10.1056/NEJM198212163072503
14.
PouderouxPVerdierEKahrilasPJ. Patterns of esophageal inhibition during swallowing, pharyngeal stimulation, and transient LES relaxation. Lower esophageal sphincter. Am J Physiol Gastrointest Liver Physiol. 2003;284(2):G242-G247. https://www.ncbi.nlm.nih.gov/pubmed/12388187
15.
HollowayRHBoeckxstaensGEEPenaginiRSifrimDASifrmDASmoutAJPM. Objective definition and detection of transient lower esophageal sphincter relaxation revisited: is there room for improvement?Neurogastroenterol Motil. 2012;24(1):54-60. doi:10.1111/j.1365-2982.2011.01812.x
16.
PandolfinoJEShiGTrueworthyBKahrilasPJ. Esophagogastric junction opening during relaxation distinguishes nonhernia reflux patients, hernia patients, and normal subjects. Gastroenterology (New York, NY 1943). 2003;125(4):1018-1024. doi:10.1016/S0016-5085(03)01210-1
17.
LinSLiHFangX. Esophageal motor dysfunctions in gastroesophageal reflux disease and therapeutic perspectives. J Neurogastroenterol Motil. 2019;25(4):499-507. doi:10.5056/jnm19081
18.
RetturaFBronziniFCampigottoM, et al.Refractory gastroesophageal reflux disease: a management update. Front Med. 2021;8:765061. doi:10.3389/fmed.2021.765061
19.
KahrilasPJShaheenNJVaeziMF. American Gastroenterological Association InstituteClinical Practice and Quality Management Committee. American Gastroenterological Association Institute Technical Review on the Management of Gastroesophageal Reflux Disease. Gastroenterology (New York, NY 1943). 2008;135(4):1392-1413.e5. doi:10.1053/j.gastro.2008.08.044
20.
ZhuYTangJShiW, et al.Can acid exposure time replace the DeMeester score in the diagnosis of gastroesophageal reflux-induced cough?Ther Adv Chronic Dis. 2021;12:20406223211056719. doi:10.1177/20406223211056719
21.
LagergrenJBergstromRLindgrenANyrenOLindgrenA. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340(11):825-831. doi:10.1056/NEJM199903183401101
22.
KaltenbachTCrockettSGersonLB. Are lifestyle measures effective in patients with gastroesophageal reflux disease?: an evidence-based approach. Arch Intern Med (1960). 2006;166(9):965-971. doi:10.1001/archinte.166.9.965
23.
ZentilinPDulbeccoPBilardiC, et al.Circadian pattern of intragastric acidity in patients with non-erosive reflux disease (NERD). Aliment Pharmacol Ther. 2003;17(3):353-359. doi:10.1046/j.1365-2036.2003.01422.x
FreedbergDEKimLSYangYX. The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American gastroenterological association. Gastroenterology (New York, NY 1943). 2017;152(4):706-715. doi:10.1053/j.gastro.2017.01.031
26.
InadomiJMJamalRMurataGH, et al.Step-down management of gastroesophageal reflux disease. Gastroenterology (New York, NY 1943). 2001;121(5):1095-1100. doi:10.1053/gast.2001.28649
27.
InadomiJMMcintyreLBernardLFendrickAM. Step-down from multiple- to single-dose proton pump inhibitors (PPIs): a prospective study of patients with heartburn or acid regurgitation completely relieved with PPIs. Am J Gastroenterol. 2003;98(9):1940-1944. doi:10.1111/j.1572-0241.2003.07665.x
28.
AbdallahJGeorgeNYamasakiTGanocySFassR. Most patients with gastroesophageal reflux disease who failed proton pump inhibitor therapy also have functional esophageal disorders. Clin Gastroenterol Hepatol. 2019;17(6):1073-1080. doi:10.1016/j.cgh.2018.06.018
29.
SavarinoEMartinucciIFurnariM, et al.Vonoprazan for treatment of gastroesophageal reflux: pharmacodynamic and pharmacokinetic considerations. Expet Opin Drug Metabol Toxicol. 2016;12(11):1333-1341. doi:10.1080/17425255.2016.1214714
30.
YadlapatiRGyawaliCPPandolfinoJE. CGIT GERD Consensus Conference Participants. AGA clinical practice update on the personalized approach to the evaluation and management of GERD: expert review. Clin Gastroenterol Hepatol. 2022;20(5):984-994.e1. doi:10.1016/j.cgh.2022.01.025
31.
LeimanDARiffBPMorganS, et al.Alginate therapy is effective treatment for GERD symptoms: a systematic review and meta-analysis. Dis Esophagus. 2017;30(5):1-9. doi:10.1093/dote/dow020
32.
VelaMFTutuianRKatzPOCastellDO. Baclofen decreases acid and non-acid post-prandial gastro-oesophageal reflux measured by combined multichannel intraluminal impedance and pH. Aliment Pharmacol Ther. 2003;17(2):243-251. doi:10.1046/j.1365-2036.2003.01394.x
33.
MattioliSLugaresiMLPierluigiMDi SimoneMPD’OvidioF. Review article: indications for anti-reflux surgery in gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2003;17(Suppl 2):60-67. doi:10.1046/j.1365-2036.17.s2.4.x
34.
MooreMAfanehCBenhuriDAntonacciCAbelsonJZarnegarR. Gastroesophageal reflux disease: a review of surgical decision making. World J Gastrointest Surg. 2016;8(1):77-83. doi:10.4240/wjgs.v8.i1.77
35.
SlaterBJDirksRCMcKinleySK, et al.SAGES guidelines for the surgical treatment of gastroesophageal reflux (GERD). Surg Endosc. 2021;35(9):4903-4917. doi:10.1007/s00464-021-08625-5
36.
YadlapatiRVaeziMFVelaMF, et al.Management options for patients with GERD and persistent symptoms on proton pump inhibitors: recommendations from an expert panel. Am J Gastroenterol. 2018;113(7):980-986. doi:10.1038/s41395-018-0045-4
37.
StylopoulosNRattnerDW. The history of hiatal hernia surgery: from bowditch to laparoscopy. Ann Surg. 2005;241(1):185-193. doi:10.1097/01.sla.0000149430.83220.7f
38.
SpechlerSJHunterJGJonesKM, et al.Randomized trial of medical versus surgical treatment for refractory heartburn. N Engl J Med. 2019;381(16):1513-1523. doi:10.1056/NEJMoa1811424
39.
LudemannRWatsonDIJamiesonGGGamePADevittPG. Five-year follow-up of a randomized clinical trial of laparoscopic total versus anterior 180 degrees fundoplication. Br J Surg. 2005;92(2):240-243. doi:10.1002/bjs.4762
40.
JobeBAKahrilasPJVernonAH, et al.Endoscopic appraisal of the gastroesophageal valve after antireflux surgery. Am J Gastroenterol. 2004;99(2):233-243. doi:10.1111/j.1572-0241.2004.04042.x
41.
DuXWuJMHuZW, et al.Laparoscopic nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease: a meta-analysis and systematic review. Medicine (Baltim). 2017;96(37):e8085. doi:10.1097/MD.0000000000008085
42.
MemonMASubramanyaMSHossainMBYunusRMKhanSMemonB. Laparoscopic Anterior Versus Posterior Fundoplication for Gastro-esophageal Reflux Disease: A Meta-analysis and Systematic Review. World J Surg. 2015;39(4):981-996. doi:10.1007/s00268-014-2889-0
43.
DuXHuZYanCZhangCWangZWuJ. A meta-analysis of long follow-up outcomes of laparoscopic Nissen (total) versus Toupet (270°) fundoplication for gastro-esophageal reflux disease based on randomized controlled trials in adults. BMC Gastroenterol. 2016;16(1):88. doi:10.1186/s12876-016-0502-8
44.
TianZWangBShanCZhangWJiangDQiuM. A meta-analysis of randomized controlled trials to compare long-term outcomes of nissen and toupet fundoplication for gastroesophageal reflux disease. PLoS One. 2015;10(6):e0127627. doi:10.1371/journal.pone.0127627
45.
YadlapatiRHungnessESPandolfinoJE. Complications of antireflux surgery. Am J Gastroenterol. 2018;113(8):1137-1147. doi:10.1038/s41395-018-0115-7
46.
SkublenyDSwitzerNJDangJ, et al.LINX® magnetic esophageal sphincter augmentation versus Nissen fundoplication for gastroesophageal reflux disease: a systematic review and meta-analysis. Surg Endosc. 2017;31(8):3078-3084. doi:10.1007/s00464-016-5370-3
47.
GanzRAPetersJHHorganS, et al.Esophageal sphincter device for gastroesophageal reflux disease. N Engl J Med. 2013;368(8):719-727. doi:10.1056/NEJMoa1205544
48.
GanzRAEdmundowiczSATaiganidesPA, et al.Long-term outcomes of patients receiving a magnetic sphincter augmentation device for gastroesophageal reflux. Clin Gastroenterol Hepatol. 2016;14(5):671-677. doi:10.1016/j.cgh.2015.05.028
49.
BuckleyFPBellRCWFreemanKDoggettSHeidrickR. Favorable results from a prospective evaluation of 200 patients with large hiatal hernias undergoing LINX magnetic sphincter augmentation. Surg Endosc. 2018;32(4):1762-1768. doi:10.1007/s00464-017-5859-4
50.
AiolfiAAstiEBernardiD, et al.Early results of magnetic sphincter augmentation versus fundoplication for gastroesophageal reflux disease: Systematic review and meta-analysis. Int J Surg. 2018;52:82-88. doi:10.1016/j.ijsu.2018.02.041
51.
NelsonLGGonzalezRHainesKGallagherSFMurrMM. Amelioration of gastroesophageal reflux symptoms following Roux-en-y gastric bypass for clinically significant obesity. Am Surg. 2005;71(11):950-953. doi:10.1177/000313480507101109
BraghettoIKornOCsendesAGutiérrezLValladaresHChaconM. Laparoscopic treatment of obese patients with gastroesophageal reflux disease and barrett’s esophagus: a prospective study. Obes Surg. 2012;22(5):764-772. doi:10.1007/s11695-011-0531-x
54.
PattersonEJDavisDGKhajancheeYSwanströmLL. Comparison of objective outcomes following laparoscopic Nissen fundoplication versus laparoscopic gastric bypass in the morbidly obese with heartburn. Surg Endosc. 2003;17(10):1561-1565. doi:10.1007/s00464-002-8955-y
55.
PerezARMoncureACRattnerDW. Obesity adversely affects the outcome of antireflux operations. Surg Endosc. 2001;15(9):986-989. doi:10.1007/s004640000392
56.
NgVVBoothMIStratfordJJJonesLSohanpalJDehnTCB. Laparoscopic anti-reflux surgery is effective in obese patients with gastro-oesophageal reflux disease. Ann R Coll Surg Engl. 2007;89(7):696-702. doi:10.1308/003588407X205323
57.
RodríguezLGómezBRodriguezP, et al.Two-year results of intermittent electrical stimulation of the lower esophageal sphincter treatment of gastroesophageal reflux disease. Surgery. 2015;157(3):556-567. doi:10.1016/j.surg.2014.10.012
58.
KappelleWFWBredenoordAJConchilloJM, et al.Electrical stimulation therapy of the lower oesophageal sphincter for refractory gastro-oesophageal reflux disease-interim results of an international multicentre trial. Aliment Pharmacol Ther. 2015;42(5):614-625. doi:10.1111/apt.13306
59.
HuangXChenSZhaoH, et al.Efficacy of transoral incisionless fundoplication (TIF) for the treatment of GERD: a systematic review with meta-analysis. Surg Endosc. 2017;31(3):1032-1044. doi:10.1007/s00464-016-5111-7
60.
YewKCChuahSK. Antireflux endoluminal therapies: past and present. Gastroenterol Res Pract. 2013;2013:481417-481426. doi:10.1155/2013/481417
61.
XiePYanJYeL, et al.Efficacy of different endoscopic treatments in patients with gastroesophageal reflux disease: a systematic review and network meta-analysis. Surg Endosc. 2021;35(4):1500-1510. doi:10.1007/s00464-021-08386-1
62.
GersonLStouchBLobonţiuA. Transoral incisionless fundoplication (TIF 2.0): a meta-analysis of three randomized, controlled clinical trials. Chirurgia (Bucharest, Romania: 1990). 2018;113(2):173-184. doi:10.21614/chirurgia.113.2.173
63.
JanuPShughouryABVenkatK, et al.Laparoscopic hiatal hernia repair followed by transoral incisionless fundoplication with EsophyX Device (HH + TIF): efficacy and safety in two community hospitals. Surg Innovat. 2019;26(6):675-686. doi:10.1177/1553350619869449
64.
ChoiAYRoccatoMKSamarasenaJB, et al.Novel interdisciplinary approach to GERD: concomitant laparoscopic hiatal hernia repair with transoral incisionless fundoplication. J Am Coll Surg. 2021;232(3):309-318. doi:10.1016/j.jamcollsurg.2020.11.021
65.
GisiCWangKKhanF, et al.Efficacy and patient satisfaction of single-session transoral incisionless fundoplication and laparoscopic hernia repair. Surg Endosc. 2021;35(2):921-927. doi:10.1007/s00464-020-07796-x
66.
FranciosaMMashimoH. Stretta radiofrequency treatment for GERD: a safe and effective modality. Am J Gastroenterol. 2013;108(10):1654-1655. doi:10.1038/ajg.2013.275
67.
LipkaSKumarARichterJE. No evidence for efficacy of radiofrequency ablation for treatment of gastroesophageal reflux disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2015;13(6):1058-1067.e1. doi:10.1016/j.cgh.2014.10.013
68.
FassRCahnFScottiDJGregoryDA. Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease. Surg Endosc. 2017;31(12):4865-4882. doi:10.1007/s00464-017-5431-2
69.
PearlJPauliEDunkinBStefanidisD. SAGES endoluminal treatments for GERD. Surg Endosc. 2017;31(10):3783-3790. doi:10.1007/s00464-017-5639-1
70.
Hernández MondragónOVZamarripa MottúRAGarcía ContrerasLF, et al.Clinical feasibility of a new antireflux ablation therapy on gastroesophageal reflux disease (with video). Gastrointest Endosc. 2020;92(6):1190-1201. doi:10.1016/j.gie.2020.04.046
71.
RandhawaNKhalyfaAKhanMRoebuckCInamMAyubK. Utilization of antireflux mucosectomy and resection and plication: a novel approach for the management of recurrent gastroesophageal reflux disease after prior Nissen fundoplication or transoral incisionless fundoplication. J Clin Med. 2022;11(23):7141. doi:10.3390/jcm11237141
72.
InoueHItoHIkedaH, et al.Anti-reflux mucosectomy for gastroesophageal reflux disease in the absence of hiatus hernia: a pilot study. Ann Gastroenterol. 2014;27(4):346-351. https://www.ncbi.nlm.nih.gov/pubmed/25330784
73.
SumiKInoueHKobayashiY, et al.Endoscopic treatment of proton pump inhibitor-refractory gastroesophageal reflux disease with anti-reflux mucosectomy: Experience of 109 cases. Dig Endosc. 2021;33(3):347-354. doi:10.1111/den.13727
74.
Rodríguez de SantiagoESanchez-VegazoCTPeñasB, et al.Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis. Endosc Int Open. 2021;9(11):E1740-E1751. doi:10.1055/a-1552-3239
75.
MannRGajendranMPerisettiAGoyalHSaligramSUmapathyC. advanced endoscopic imaging and interventions in GERD: an update and future directions. Front Med. 2021;8:728696. doi:10.3389/fmed.2021.728696
76.
HeloNWuAMoonEWangW. Visceral artery embolization after endoscopic injection of Enteryx for gastroesophageal reflux disease. J Radiol Case Rep. 2014;8(9):21-24. doi:10.3941/jrcr.v8i9.1861
77.
ShakerRBabaeiANainiSR. Prevention of esophagopharyngeal reflux by augmenting the upper esophageal sphincter pressure barrier. Laryngoscope. 2014;124(10):2268-2274. doi:10.1002/lary.24735
