Plication of the gastroesophageal junction by endoscopic suturing can improve symptoms and reduce acid exposure in patients with gastroesophageal reflux disease (GERD).
In this study, physicians from Australia assessed the impact of endoscopic suturing of the gastroesophageal junction on lower esophageal sphincter (LES) function in patients with GERD.
The team evaluated 15 patients with GERD.
|Suturing reduced 24-hour esophageal acid exposure from 10% to 7%.|
|American Journal of Gastroenterology|
Patients each had 2 plications performed 1 cm below the gastroesophageal junction.
The physicians performed endoscopy, and combined postprandial esophageal manometry and pH monitoring both before and 6 months after treatment.
They also performed 24-hour ambulatory pH monitoring and symptom assessment before, and 6 and 12 months after treatment.
The team found that 6 months after treatment, the rate of transient LES relaxations (tLESRs) was decreased by 37%.
In addition, basal LES pressure had increased from a mean 4.3 mmHg to 6.2 mmHg.
The physicians found that the rate of postprandial reflux events and acid exposure time were not altered by the treatment.
They determined that endoscopic suturing reduced 24-hour esophageal acid exposure from 10% to 7% at 6 months. This reduction was found to be sustained 12 months after treatment.
Dr William Tam's team concluded, "In patients with GERD, endoscopic suturing of the gastroesophageal junction results in a reduction in the rate of tLESRs, and an increase in basal LES pressure".
"These changes in LES function result in only a modest reduction in gastroesophageal reflux".