Stretta® Therapy for Reflux in GERD
Stretta® Therapy is an electrosurgical process of tissue coagulation developed by Mederi Therapeutics inc. of Greenwich, Connecticut which treats reflux in GERD by directing radiofrequency energy at the lower esophageal sphincter and gastric cardia. The treatment creates lesions which contract as they heal helping to reduce the symptoms suffered.
The treatment is carried out as an outpatient process which takes about an hour to complete and it leaves no visible marks or scars as Mederi’s specially designed catheter gains access to the treatment area in esophagus via the mouth. Some sedation is needed but most patients are usually discharged one or two hours after the procedure and can return to work and carry out all their normal activities the day after. Patients are advised to follow a liquid diet for the 24 hours following the procedure and to eat only soft foods for a further seven days.
The radiofrequency energy is delivered into the soft tissue through four small electrode needles. This energy warms the water in the tissue to 85° Celsius or 185° Fahrenheit which creates small thermal lesions. This process is which repeated several times in the area being treated. Some contraction takes place at the time of treatment while the remainder takes place during the healing process in the following six to twelve month period. The patient normally continues to take GERD Medication for about two months after the therapy and then this medication it may be reduced or discontinued according to the patient’s response.
Stretta Therapy is aimed at those with mild to moderate GERD, who either do not respond to or tolerate the traditional drug therapy and who are looking for a less invasive process than surgery. Due to its less invasive nature Stretta has a significantly lower complication rate and fewer associated morbidities than surgery but it also does not prevent surgery from taking place if the procedure should be unsuccessful. It is also possible to repeat the procedure.
Mederi consider that the ideal Stretta patient will have:
- non-erosive or non-ulcerative esophagitis not responding to drugs
- a diaphragmatic hiatus of less than 3 cm
- a hiatal hernia of less than 2 cm
- extra-esophageal manifestations of GERD
- reflux related gastroparesis
Stretta has also been shown to be effective where the patient:
- has a hyper sensitive esophagus, traditional PPIs don’t work for them as they are not refluxing acid
- develops GERD after a Gastric Bypass
- has failed Nissen fundoplication and demonstrates GERD