What are the treatment options for GORD?
Treatment options for GORD often depend on the severity of the condition and may include the following:
Lifestyle Modifications
Changes in lifestyle may relieve GORD symptoms in some patients.
- Eliminate coffee, alcohol, smoking
- Avoid eating close to bedtime
- Sleep with the head of the bed elevated
- Eliminate spicy or fatty foods, and citrus or tomato products
Prescription Medications
These medications provide symptomatic relief but are generally required for the lifetime of the patient.
The following drugs work by decreasing acid production:
- Proton-Pump inhibitors (PPis)
- H2-receptor antagonists
Anti-Reflux Surgery
This surgery involves wrapping the stomach around the oesophagus to improve the barrier function of the lower oesophageal sphincter.
- 2-4 hour procedure
- General Anaesthesia
- 1-4 day hospital stay
- 1-3 weeks back to work
For those who suffer from chronic heartburn and are considering a surgical intervention, Stretta may be an optimal and less invasive option.
What is Stretta Therapy?
Stretta is a non-surgical, outpatient procedure that treats the underlying cause of GORD – a weak muscle between the stomach and oesophagus.
Stretta has been shown to:
- Significantly reduce GORD symptoms
- Eliminate or decrease medications
- Decrease acid exposure
- Improve quality of life
The Stretta Procedure
Stretta Therapy is a non-surgical, minimally invasive outpatient procedure that takes approximately 45 minutes to perform. Patients are sedated and the Stretta Catheter is passed through the mouth so there are no visible cuts or scars as a result of the procedure.
Patients typically can go home 1 – 2 hours after the procedure. Most patients are able to return to work and their normal activities the day after treatment so there is minimal interruption to everyday life.
How Stretta Works
The Physician places the Stretta catheter through patient’s mouth and into the valve between the stomach and oesophagus. Radiofrequency energy is delivered at multiple levels to the muscle of the lower oesophageal sphincter and stimulates the muscle to grow over time* resulting in a thicker muscle, improved barrier function and prevention of all types of reflux events (acid, bile, etc.)
*Herman, et al. Colorectal Disease: May 2015 – 17:433-440
The Healing Power of Radiofrequency
Radiofrequency energy is widely used in healthcare:
- Cardiologists use RF to treat atrial fibrillation
- Urologists use RF for treating prostate enlargement
- ENTs use RF to eliminate snoring and sleep apnea
- RF is used in cosmetic procedures for body contouring, skin rejuvenation and tightening
Animal studies show that the technology used in Stretta may increase smooth muscle and improve collagen in the treatment zone.*
*Herman, et al. Colorectal Disease: May 2015 – 17:433-440
Long-Term Outcomes of Stretta Therapy
Stretta treatment has been widely studied:
- More than 20,000 Stretta procedures performed
- 40 clinical studies conclude Stretta safe and effective
- Low complication rate <1% (similar to EGD)
- 93% patient satisfaction after Stretta
- Long term data
- 4-year follow-up 86% of patients off daily PPIs
- 8-year follow-up 72% of patients off daily PPIs
- 10-year follow-up 64-72% of patients off PPIs
Perry et al. Surgical Endocopy27: 2658-2672 Noar, et al August 2014. Surgical Endoscopy 28, 2323-2333
What to Expect After Stretta
- Expect to feel very tired for rest of the day
- Most common side effect is a sore throat or mild chest soreness (may continue for 1-5 days)
- Some patients feel bloated with increased belching and gas
- Resume normal activities as tolerated the next day
- Follow all post-procedure instructions provided
Continue taking your acid controlling medications until instructed by your physician (at least 2-months after Stretta)
- Do not expect symptoms to improve immediately
- The effects develop slowly over time
- Some patients improve faster than others
- Your physician will begin to wean you off of your PPI medications approximately 2-months after Stretta
- Most patients start to see improvements in 2-4 months but sometimes it may take as long as 8-12 months
Post Stretta Patient Instructions
- Avoid instrumentation of the oesophagus for at least one month after treatment, specifically the passage of a nasogastric tube.
- Refrain from use of oral NSAIDS for 14-days after Stretta.
- Use liquid acetaminophen, with or without codeine or equivalent preparation, for post treatment analgesia.
- Crush all medications or use liquid preparations of all medications, for at least one month after treatment.
- Modify diet post Stretta: full liquids for 24 hrs, soft diet for 2-weeks.
- Continue previous GORD medication regimen for 2-months after the Stretta procedure. Notify the physician if any of the following symptoms occur: Fever, chest pain, nausea, vomiting, bleeding, shortness of breath, increasing abdominal discomfort, difficulty swallowing, tachycardia.
What are the advantages of Stretta
- Middle option fits between medications and surgery
- Non-surgical and outpatient procedure
- Low complication rate
- Does not alter patient anatomy
- Widely studied with long-term follow-up
- Cost effective when compared to long-term medications or surgery
Patient profile suitable for Stretta Treatment
The Stretta treatment is suitable for patients who:
- Do not respond completely to PPIs
- Have drug interactions with or are intolerant of PPIs
- Are concerned about side effects of long-term PPI use
- Want to avoid anti-reflux surgery
- Experience non-erosive reflux (NERD)
- Have respiratory GORD symptoms (cough, asthma, etc)
- Have recurring reflux after anti-reflux surgery
- Still have GORD after bariatric surgery
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