• The technology described in this briefing is IQoro. It is a neuromuscular training device used for improving symptoms related to hiatus hernia by strengthening the oesophagus and diaphragm. It is initially used daily for 3 to 6 months, with follow up maintenance use dependent upon individual need.

  • The innovative aspects are that IQoro is the only device available for treating hiatus hernia with oral, neuromuscular training and an exercise regime.

  • The intended place in therapy would be as an alternative to long-term proton pump inhibitor (PPI) treatment or laparascopic fundoplication surgery in people with hiatus hernia.

  • The main points from the evidence summarised in this briefing are from 3 non-comparative, observational studies including 148 adults in Swedish ear, nose and throat clinics. They show that IQoro may improve symptoms related to hiatus hernia when used for 6 to 8 months in people with long-term hiatus hernia.

  • Key uncertainties around the evidence are that it is limited in quantity and quality. The effect of IQoro may be overestimated because of a lack of a control group. A study comparing IQoro with standard NHS care would help address this.

  • The cost of IQoro is £116 per unit (exclusive of VAT). The resource impact would be greater than standard care, but costs may be offset by reducing long-term PPI maintenance.