title: Endotherapy for and tailored approaches to treating GERD, and refractory GERD.
abstract: This paper presents commentaries on how endoluminal antireflux procedures compare to laparoscopic fundoplication; new endoscopic procedures being studied to treat refractory gastroesophageal reflux disease (GERD); the new Stretta; the relationship between obesity and proton pump inhibitor (PPI) resistance; data concerning acid hypersensitivity and sensory receptors (vallinoid, TRPV1) causing refractory GERD; whether microscopic esophagitis is relevant in determining symptoms of non-erosive reflux disease (NERD); how concomitant functional gastrointestinal disorders affect the PPI response in NERD; the evidence that a functional esophagus is associated with inflammatory bowel syndrome (IBS); the role of GABA agonists in the treatment of refractory GERD; the role of biofeedback and antidepressants in refractory GERD; and endoluminal fundoplication using the EsophyX device.
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: G Richard
authors.initials: GR
authors.lastname: Locke
authors.affiliation: Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: John
authors.initials: J
authors.lastname: Horwhat
authors.affiliation: VA Boston Healthcare System/Harvard Medical School, Boston, Massachusetts.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mashimo
authors.affiliation: Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Savarino
authors.affiliation: Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Zentilin
authors.affiliation: Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savarino
authors.affiliation: Department of Gastroenterology, CHU Bordeaux, Saint Andre Hospital, Bordeaux, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Zerbib
authors.affiliation: Department of Gastroenterology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Armbruster
authors.affiliation: Department of Gastroenterology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Roy K
authors.initials: RK
authors.lastname: Wong
authors.affiliation: Department of Gastroenterology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Fouad
authors.initials: F
authors.lastname: Moawad
mesh_terms: D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: GABA agonists; IBS; NERD; PPI; TRPV1; antidepressants; functional heartburn