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Endoscopic injection of bulking agents for gastro-oesophageal reflux disease

Guidance issued Guidance issued
 
IP Guidance Number: IPG55
 
Summary:

The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Scotland and Wales on endoscopic injection of bulking agents for gastro-oesophageal reflux disease in April 2004. This Guidance is currently under review. If you wish to be updated to any developments with this procedure, you can express an interest at the top of the page.

Until the review is published the NHS should continue to follow the recommendations in the guidance below

Description:

Gastro-oesophageal reflux disease (GORD) is a common condition that can have a significant impact on the quality of life of an individual. It is caused by failure of the sphincter mechanism at the lower end of the oesophagus. Symptoms of GORD can be broadly grouped into those directly related to reflux episodes such as heartburn, regurgitation and waterbrash; and those symptoms caused by complications of reflux disease, including dysphagia and respiratory symptoms.

Drug therapy, combined with lifestyle modifications, is the standard treatment for patients with mild symptomatic GORD. Patients with more severe symptoms or oesophagitis may be treated with more intensive drug therapy and anti-reflux surgery may be needed.

The patient is sedated and given an injection of antibiotics. A needle catheter is then introduced through an endoscope into the gastro-oesophageal junction. This catheter is filled with a bio-compatible polymer and solvent and is used to inject or implant the polymer into the gastro-oesophageal junction. The injection is made along the muscle layer or deep submucosal layer of the cardia. Multiple injection/implants (often four) are performed in a circumferential manner around the oesophagus under fluoroscopic and endoscopic control.

Arrangements:

Special

Topic Area:

Digestive system
Surgical procedures

Specialty:

Gastro-enterology

Specialist advice has
been sought from:
Date notified to NICE: 27 June 2003
Guidance Publication Date: 28 April 2004
Contact Details:
Project Manager
(for general enquiries or comments)
Ben Doak
ip@nice.org.uk
Technical Lead
(for procedure specific enquiries or comments)
Sally Wortley
ip@nice.org.uk
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA


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