Surgical and Endoscopic Therapies for GERD

Gastroesophageal reflux disease (GERD) affects quality of life and may cause erosive esophagitis, Barrett esophagus, and esophageal strictures and adenocarcinoma.1 The American Society for Gastrointestinal Endoscopy (ASGE) recommends initial management with behavioral modifications (eg, avoidance of meals within 3 hours of bedtime, elevating head of bed while asleep)2 prior to or combined with medications, such as proton pump inhibitors (PPIs), histamine-2 receptor antagonists, or potassium-competitive acid blockers (eg, vonoprazan). However, up to 54.1% of patients have persistent, troublesome symptoms (ie, heartburn or regurgitation for ≥2 d/wk) despite optimal medical therapy.3