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conferenceseries
.com
Volume 8
Journal of Gastrointestinal & Digestive System
Gastro Meet 2018
August 06-07, 2018
August 06-07, 2018 Abu Dhabi, UAE
Gastroenterology and Digestive
Disorders
16
th
International Conference on
Endotherapy in refractory/PPI dependant GERD
Rakesh kalapala
Asian Institute of Gastroenterology, India
G
astro-esophageal reflux disease (GERD), affects one third of the population worldwide and prevalence in India ranges between
8 to 19%. Majority of the patients have impaired Quality of Life (QOL) due to symptoms such as heartburn, regurgitation
or dysphagia and the long term complications associated with it. Current treatments modalities include lifestyle modifications,
long term pharmacological therapies, surgical fundoplication and more recently, endoscopic procedures. About 10% of patients
with endoscopically proven reflux esophagitis are resistant to Proton Pump Inhibitors (PPIs). Further, almost 20% of patients
have inadequate symptom control resulting in heartburn and regurgitation that cause detrimental effects on the quality of life.
Also, potential side effects of long-term PPIs use (B12 deficiency; iron deficiency; hypomagnesaemia; increased susceptibility
to pneumonia; enteric infections; fractures and hyper-gastrinemia), results in many patients discontinuing treatment. Surgical
options for GERD have their limitations due to increased costs, hospitalization, complication rates and delayed recovery. Data from
5 year LOTUS study suggests that 15–20% of patients who have undergone fundoplication may have GERD symptoms. Uncontrolled
GERD leading to acid inducednon-cardiac chest pain results in a significant decrease inquality of life, productivity at work and economic
burden on the patients. In addition, it is associated with worrisome complications such as strictures, Barrett’s esophagus and esophageal
adenocarcinoma. The rising concern of long term side effects of the popular proton-pump inhibitors and the more recent evidence
raising doubts about the durability of fundoplication have spurred re-interest in endoscopic procedures such as Stretta, GERD-X etc.
to treat reflux disorder. Several clinical studies including a systematic review showed that the Stretta procedure improves GERD
symptoms, quality of life and esophageal acid exposure and eliminates the need for anti-secretory drugs in majority of patients.
drkalpala@gmail.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C3-071