Current evidence on the safety and efficacy of endoscopic injection of bulking agents for gastro-oesophageal reflux disease does not appear adequate for this procedure to be used without special arrangements for consent and for audit or research.
Clinicians wishing to undertake endoscopic injection of bulking agents for gastro-oesophageal reflux disease should take the following action:
Inform the clinical governance leads in their Trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. Use of the information for the public is recommended.
Audit and review clinical outcomes of all patients having endoscopic injection of bulking agents for gastro-oesophageal reflux disease.
Publication of safety and efficacy outcomes will be useful in reducing the current uncertainty. NICE may review the procedure upon publication of further evidence.