Role of ARMA in Selective Subset of Refractory GERD Patients.

Patients will be instructed to fast for 6 hours pre-ARMA, the Procedure will be performed under propofol-based sedation. Patients will be in the left lateral decubitus position. The stomach will be insufflated with CO2 to visualize the cardia in retroflex view.

"UGI Endoscopy will be performed under propofol based sedation with scope kept inside for atleast 5 minutes.~Follow up will include objective evaluation of reflux disease with: upper endoscopy, esophageal manometry, pHmetry, reflux questionnaire."