Stretta procedure

Stretta procedure is a minimally invasive endoscopic treatment used to alleviate symptoms of gastroesophageal reflux disease (GERD), a condition in which stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. The Stretta procedure is designed for patients who do not respond well to medications or who wish to avoid more invasive surgery.

Overview

The Stretta procedure involves the delivery of radiofrequency (RF) energy to the muscle tissue between the stomach and esophagus, known as the lower esophageal sphincter (LES). The RF energy heats the tissue, causing tiny burns that heal and form scar tissue. This scar tissue tightens the sphincter, thus reducing the ability of acid to reflux up into the esophagus. The procedure is performed using a special catheter passed through the mouth (endoscopically), avoiding the need for incisions.

Indications

The Stretta procedure is indicated for patients with GERD who have not had success with proton pump inhibitors (PPIs) or other GERD medications, or for those who prefer an alternative to lifelong medication or more invasive surgical options. It is particularly suited for patients with a hiatal hernia less than 2 cm in size.

Procedure

The Stretta procedure is typically performed on an outpatient basis, requiring no overnight stay in the hospital. It usually takes less than an hour to complete. During the procedure: 1. The patient is sedated to ensure comfort. 2. A thin, flexible tube (endoscope) with the Stretta catheter attached is inserted through the mouth and guided to the LES. 3. The catheter emits RF energy to the LES and upper part of the stomach. 4. The catheter is withdrawn, and the procedure is complete.

Patients can usually return to their normal activities within a day, although they may be advised to follow a soft diet for a short period after the procedure.

Efficacy

Studies have shown that the Stretta procedure can significantly reduce GERD symptoms, improve quality of life, and decrease the need for GERD medications. The effects of the procedure are not immediate; it may take three to six months to see significant improvement as the treated tissue heals and remodels.

Risks and Complications

The Stretta procedure is considered safe, but like all medical procedures, it carries some risks. Complications are rare but can include sore throat, nausea, vomiting, bloating, and, in very rare cases, perforation of the esophagus or stomach, bleeding, or infection.

Conclusion

The Stretta procedure offers an effective and minimally invasive option for managing GERD symptoms in patients who are not adequately controlled with medication or who wish to avoid more invasive surgery. It has a good safety profile and can significantly improve the quality of life for those suffering from GERD.