[Endoscopic treatment of gastroesophageal reflux disease--new possibilities].

Gastro-esophageal reflux disease (GERD) is one of the most important problems of gastroenterology at present. The symptoms of GERD have negative influence of patients' life on a daily basis. The principal aim of reflux disease treatment is to eliminate or alleviate the symptoms, to heal tissue damages and to reduce the frequency and duration of recurrences. Lifestyle and dietary modification are of only limited value in GERD treatment. Proton pump inhibitors (PPI) are the mainstay of GERD pharmacotherapy for both initial episode and long-term management. Surgical treatment is indicated in: complicated GERD, in patients who need high effective dose of medication, young patients who need lifelong PPI, patients with big hiatus hernia. Laparoscopic Nissen fundoplication has become the operation of choice. Nevertheless patients who have undergone fundoplication may experience adverse post operative complication. The useful alternatives in the management of GERD may indeed eventually prove the new endoscopic methods of minimally invasive treatment which are currently under thorough evaluation. The most promising methods of endoscopic treatment of GERD have been discussed: radiofrequency ablation (the Streett's procedure), endoscopic gastroplasty, endoscopic implantation of biopolymer hydrogel prosthesis.