Esophageal Sphincter Device for Gastroesophageal Reflux Disease

In this trial, a magnetic device to augment the lower esophageal sphincter was implanted in 100 patients with gastroesophageal reflux disease. At 1 year, esophageal acid exposure had decreased and symptoms had improved. Six patients had serious adverse events. The fundamental pathologic abnormality in gastroesophageal reflux disease is an incompetent lower esophageal sphincter. 1 – 3 First-line therapy for gastroesophageal reflux disease is acid suppression, usually with proton-pump inhibitors. Although effective, proton-pump inhibitors provide incomplete control of reflux symptoms in up to 40% of patients. 4 – 6 A partial response can occur because these drugs do not address an incompetent sphincter or prevent reflux; consequently, some patients have only partial relief from symptoms and seek alternative treatment if their quality of life is compromised. At present, the only established option for these patients is antireflux surgery, typically Nissen fundoplication. However, the acceptance . . .