Endoscopic therapy for GERD--baking, sewing, or stuffing: an evidence-based perspective.

The concept of using endoscopic therapy for the treatment of symptomatic gastroesophageal reflux disease (GERD) is a relatively recent development. Currently, three basic techniques are approved for use in the United States. To date, clinical trials have examined either a thermal approach, endoscopic suturing, or injection intervention in the area of the lower esophageal sphincter. However, the trials for each type of endoscopically directed therapy have varied in methodologic design and data analysis. It is important to recognize these differences when attempting to compare the efficacy and outcomes for each endoscopic therapy. Additionally, the risk/benefit profile must be carefully evaluated for each of these interventions before considering it a viable treatment strategy.