Gastroesophageal reflux disease (GERD) affects around 20% of adults in Western countries, causing heartburn, regurgitation, and in some cases esophageal damage. While proton pump inhibitors (PPIs) control symptoms for most, many people have ongoing symptoms or want to reduce long-term medication use.
What's actually going on in research
Potassium-competitive acid blockers (P-CABs) like vonoprazan produce faster and more complete acid suppression than PPIs and are being tested for GERD, erosive esophagitis, and H. pylori eradication. Magnetic sphincter augmentation (LINX device) and newer antireflux procedures are being compared with laparoscopic fundoplication for symptom control and dysphagia rate. Alginate-based and other barrier-forming treatments are in trials for breakthrough symptoms in PPI users.
Potassium-competitive acid blockers
P-CABs like vonoprazan achieve stronger and faster acid suppression than PPIs. Trials are comparing them to standard PPIs for healing erosive esophagitis and controlling GERD symptoms long-term.
Magnetic sphincter augmentation
The LINX magnetic bead bracelet reinforces the lower esophageal sphincter and is being compared with laparoscopic fundoplication in trials for durability, side effects, and patient preference.
Endoscopic anti-reflux procedures
Transoral incisionless fundoplication (TIF) and radiofrequency ablation of the sphincter are being compared with surgery and medical therapy in controlled trials.
What to know before you search
Eligibility depends on symptom frequency, erosive vs. non-erosive disease, prior PPI use and response, and for procedure trials, anatomic assessment of the hiatus.
What types of trials are currently open
- Drug trials — Testing new acid-suppressive agents, P-CABs, and combination therapies for GERD symptom control.
- Surgical trials — Comparing fundoplication techniques and magnetic sphincter augmentation for durable reflux control.
- Endoscopic procedure trials — Evaluating TIF, Stretta, and other endoscopic approaches as alternatives to surgery or medication.
- Barrett's esophagus trials — Testing endoscopic ablation and cancer surveillance strategies in GERD-related Barrett's esophagus.
- Lifestyle trials — Testing dietary, weight loss, and positional interventions on GERD frequency and severity.
Recently added Gastroesophageal Reflux Disease trials
Transoral Incisional Fundoplication (TIF) for Patients Suffering From Gastroesophageal Reflux Disease in an Asian Population
Transoral incisionless fundoplication (TIF) has become a widely used intervention to restore the valve at the gastroesophageal junction in selected patients suffering from gastroesophageal reflux disease (GERD). More than 20,000 procedures have been performed worldwide. TIF with EsophyX device reconfigures the tissue to establish an omega-shaped full-thickness gastroesophageal valve from inside the stomach. The procedure creates serosa to serosa plications which include the muscle layers and constructs valves 3-5cm long, taking in 200-270 degrees of the circumference, and deploying multiple non-absorbable polypropylene fasteners through the two layers in a circumferential patten around the gastroesophageal junction. Data so far indicate that, in the majority of patients, the procedure achieves lasting improvement in GERD symptoms measured by either pH or impedance monitoring. The technique offers an acceptable alternative to surgery, mimicking partial fundoplication, but less invasive and with no persistent side effects, in patients with proven pathological GERD with either a competent gastroesophageal valve or hiatal hernia, not longer than 3cm, who refuse, are intolerance, or are unresponsive to PPI maintenance therapy. Laparoscopic fundoplication, although still considered to be the gold-standard approach for GERD refractory to medical treatment, does involve some risk of long-term adverse events such as dysphagia (5-12%), inability to vomit or belch, gas/bloat syndrome (19%) and excessive flatulence. Several prospective observational studies and some comparative trials have proved efficacy of TIF with EsophyX in obtaining a significant reduction in the acid exposure time (AET) assessed by esophageal 24-hour pH-impedance monitoring versus sham, and in controlling both typical and atypical GERD symptoms for up to 1 to 2 years, as reported in a meta-analysis7. Outcomes at 3, 5, and 10 years have been reported in different studies and showed to be favourable. In an Italian study reporting the 10 year follow-up, the GERD-HRQL score, heartburn and regurgitation score were significantly lower than pre-procedure and did not change significantly during the follow-up. The rates of patients who had stopped or halved anti-secretive therapy 2, 3, 5, 7 and 10 years after the procedure were 86.7%, 84.4%, 73.5%, 83.3% and 91.7% respectively. This procedure, however, has not been performed in Asia patients. Asians have smaller body build and is known to have less GERD when compared to the Caucasian population. This study, therefore, is a feasibility study to perform TIF in an Asian population. In patients who fulfil the inclusion criteria, TIF will be performe under general anaesthesia. They will then be followed-up at 4 weeks, 3 months, then yearly for up to 5 years after the procedure. The anti-reflux control and adverse events will be recorded.
Diaphragmatic Training on GERD
he goal of this clinical trial is to evaluate the effects of diaphragm-oriented breathing training on patients with gastroesophageal reflux disease (GERD). This study will compare two non-invasive respiratory interventions-diaphragmatic breathing exercise (DBE) and volume-oriented incentive spirometry (VIS)-in terms of their impact on esophageal function and health-related quality of life.The main questions it aims to answer are:Does DBE or VIS improve GERD symptoms as measured by the GERD Questionnaire (GERDQ)?Do these interventions reduce esophageal acid exposure time and the number of reflux episodes?Do these interventions improve lower esophageal sphincter (LES) pressure and esophageal motility?Do these interventions improve GERD-related quality of life as measured by the GERD-HRQL questionnaire?Researchers will compare three groups: DBE, VIS, and a control group receiving standard care, to determine whether diaphragm-oriented breathing training provides additional benefits over usual management.Participants will:Be randomly assigned to one of three groups (DBE, VIS, or control)Perform the assigned intervention for 6 weeksUndergo baseline and post-intervention assessments, including symptom questionnaires and esophageal function testing Record symptoms and adherence in a daily diary
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