A Novel Endoloop Pre-test to Treat Gastroesophageal Reflux

Inclusion Criteria: * Patients with typical symptoms of GERD with symptomatic response to PPI therapy for ≥ 3 months * Patients considered for non-medical therapy, i.e. unwillingness to take life-long medication in medically-responding disease, suffering from medication side-effects or medically-intractable disease * Pathological esophageal acid exposure after discontinuation of medical therapy, proven by ambulatory 24-hour pH-monitoring with \> 5% of time a pH \< 4 and a symptom-association probability \> 95% * written informed consent Exclusion Criteria: * 24 hr acid exposure study showing abnormal esophageal acid exposure \<4% * DeMeester Score \<14.7 * hiatal hernia (\> 3 cm in length) * history of antireflux or esophageal/gastric surgery * severe psychiatric disease * Barrett's esophagus with dysplasia * esophageal stenosis/malignancy * pregnancy or lactation * history of low therapeutic compliance * other severe comorbidity (including cardiopulmonary disease, portal hypertension, collagen diseases, morbid obesity, coagulation disorder) * use of anticoagulant or immunosuppressive drugs