If you suffer from gastroesophageal reflux disease (GERD) and dislike the idea of taking medicine for the rest of your life, or if medication is not reducing your symptoms, you may want to ask your doctor about the Stretta® procedure. Recent studies have shown that about two-thirds of patients who undergo the procedure experience almost complete relief within one year. Followup studies have indicated that most of those patients are still symptom-free three years after the procedure.In the last two years, researchers at Vanderbilt University, Ponce (Puerto Rico) Gastroenterology Research, and VA Palo Alto Health Care System have published studies on the effectiveness of the procedure for treating GERD. The results show that the Stretta® procedure completely eliminates the need for proton pump inhibitors in most patients. Most patients have reduced symptoms within one month of the procedure, and are able to reduce or discontinue heartburn medication. After one year, approximately two-thirds of the patients studied had stopped taking proton pump inhibitors or other medication for heartburn. Most of them were still symptom-free after three years. Many of those who were not able to completely discontinue their medicine were able to reduce the amount of medication they take. If their symptoms recurred, they were less severe than before the Stretta® procedure. Most patients felt that their quality of life improved after the procedure.
GERD, or frequent heartburn, affects about seven percent of adults in the US. Most can control their symptoms with prescriptions or over-the-counter medications, including proton pump inhibitors such as Nexium or Prilosec. However, there are a variety of reasons patients may not want to continue treating GERD with medicine, including side effects, the medicine not working, and the medicine’s cost over a lifetime.
The Stretta® procedure is a minimally invasive operation during which the doctor uses a catheter equipped with electrodes to heat and scar some of the tissue of the lower esophageal sphincter (LES). As the tissue heals, it thickens the LES and reduces the frequency of reflux.
When performing the Stretta® procedure, the gastroenterologist will put the patient in a state of conscious sedation using a combination of painkillers and sedatives. The doctor will then insert a catheter, or tube, through the mouth and throat to the LES, the valve between the stomach and the esophagus. At the end of the catheter is a balloon with electrodes. When the catheter is in place, the balloon is expanded. The doctor then delivers radiofrequency energy through the electrodes to the tissue of the LES. The energy heats the tissue and creates thermal lesions.
As the lesions heal, the LES creates a better barrier between the stomach and the esophagus. The scarred tissue makes it more difficult for the muscle to relax, leading to greater constriction, and the muscle walls are thickened. These help prevent the occurrence of reflux, when the stomach acid splashes out of the stomach and into the esophagus.
The Stretta® procedure is non-surgical. It results in no incisions or visible scars. It is performed on an outpatient basis and usually takes less than one hour to complete. Most patients can return to work the next day. The Stretta® procedure is not an appropriate treatment for those with large hiatal hernias, Barrett’s esophagus, or those who only experience occasional heartburn.
