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Who Should Consider Endoscopic Suturing?

Endoscopic gastroplication is appropriate for most patients with chronic GERD. There are a few criteria used for selecting candidates for endoscopic gastroplication.

The following patients should probably not undergo endoscopic gastroplication:

• History of surgery of the esophagus or stomach
• Barrett’s Esophagus
• Esophageal motility dysfunction
• Inability to receive sedation
• Patients with a large hiatal hernia
• Morbid obesity
• Significant heart or lung disease

The following patients may be considered:

• Patients should show a good response to medical therapy
• Patients who are not markedly over weight
• Those with a small hiatal hernia
• Patients seeking an alternative to chronic medical therapy

If you are interested in this nonsurgical alternative to surgical or life long medical therapy there are several steps involved.

The first begins with a thorough history and physical followed by routine laboratory studies. All patients must have had an upper endoscopy. If biopsies were taken from the endoscopy, they will be reviewed at the time of your consultation.

Prior to the procedure it is necessary to have completed an esophageal motility test to evaluate the functionality of the esophagus and the LES. A 24-hour ambulatory acid monitoring test is also performed to objectively document acid reflux in the esophagus.

This test involves the placement of a small tube placed through the nose into the esophagus and helps to quantitate reflux episodes and correlate them with symptoms. These studies may also be performed at some time after the procedure to show improvement.

Please call 212-673-2721, 845-471-1354 or 877-4-GERDMD. to schedule a consultation.

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