Review	Endoscopy 2005; 37: 470-478 DOI: 10.1055/s-2005-861194
© Georg Thieme Verlag KG Stuttgart · New York
Endoscopic Treatment of Gastroesophageal Reflux Disease
V.  Annese1[*], G.  Caletti2[**], L.  Cipolletta3[**], G.  Costamagna4[**], V.  D'Onofrio5[*], G.  Leandro6[**], M.  Koch7[*], F.  Pace8[*], R.  Penagini9[*], A.  Repici10[**], E.  Ricci11[**], S.  Vigneri12[**], G.  Zaninotto13[*]
1 U.O. Gastroenterologia, Ospedale CSS-IRCCS, San Giovanni Rotondo, Italy 2 U.O. Gastroenterologia, Università di Bologna, Ospedale Castel S. Pietro Terme, Italy 3 U.O. Gastroenterologia, Ospedale Torre del Greco, Italy 4 U.O. Endoscopia Chirurgica, Policlinico “A. Gemelli”, Roma, Italy 5 U.O. Gastroenterologia, Ospedale “Moscati”, Avellino, Italy 6 U.O. Gastroenterologia, Ospedale IRCCS “De Bellis” Castellana Grotte, Italy 7 U. O. Gastroenterologia, Ospedale “S. Filippo Neri”, Roma, Italy 8 U.O. Gastroenterologia, Ospedale Universitario “L. Sacco”, Milano, Italy 9 U.O. e Cattedra di Gastroenterologia, Ospedale “Maggiore”, Milano, Italy 10 U.O. Gastroenterologia, Ospedale “Molinette”, Torino, Italy 11 U.O. Gastroenterologia, Ospedale Civile, Forlì, Italy 12 U.O. Gastroenterologia, Clinica Medica, Ospedale Civico Palermo, Italy 13 U.O. Chirurgia, Policlinico Universitario, Padova, Italy

Gastroesophageal reflux disease is a common chronic disorder which has a severe effect on the patient's quality of life. In view of the high cost of medical therapy and the limitations of surgery, a variety of endoscopic techniques have been developed for the treatment of this condition, and these have shown apparently encouraging results, at least in the short term. However, promising results have been obtained in only around two-thirds of patients over a short-term follow-up period of about 6 months. Moreover, several inconsistencies have emerged between the efficacy of this form of treatment in improving symptoms and quality of life and a lack of improvement of objective parameters, such as lower esophageal sphincter pressure and esophageal acid exposure. The authors strongly endorse the need for comprehensive evaluation of clinical evidence on this topic. After an extensive evaluation of existing literature, we suggest that controlled studies are urgently needed in order to clarify the potential of endoscopic therapy, either in terms of cost-effectiveness or in comparison with standard therapy. Meanwhile, with regard to current practice, the use of endoscopic treatment should be limited to clinical trials, which should incorporate the provision of comprehensive and unbiased information to study patients.