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The difference in objective gastroesophageal reflux disease (GERD) between POEM and LHM is modest at best and dissipates with time. Post\u2010POEM GERD can be easily managed medically in most patients without long\u2010term GERD sequelae or the need for surgical fundoplication. Emerging POEM technique modifications can further decrease GERD. Endoscopic antireflux procedures such as transoral incisionless fundoplication (TIF) or POEM\u2009+\u2009F (POEM\u2009+\u2009fundoplication) can be used in the rare cases of medication\u2010refractory GERD, but their long\u2010term efficacy remains in question. In this comprehensive review, we summarize the current status of POEM with emphasis on GERD evaluation, prevention, treatment, and comparative data vs. LHM. 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