84fe1-strettaIf you have received a positive diagnosis of gastro-oesophageal reflux disease (GORD) or laryngopharyngeal reflux (LPR) there are a number of potential treatment options available.

These can include reflux medication, dietary changes, lifestyle changes and surgery. Surgery is considered a last resort, if other measures or medication haven’t helped.

Here we look at a (so-called) minimally invasive procedure termed Stretta Therapy.

What is the Stretta Therapy?

Reflux disease often results from a weak or damaged stomach muscle valve called the Lower Oesophageal Sphincter (LOS) – at the junction of the oesophagus and the stomach – which allows stomach contents to reflux into the oesophagus. The Stretta system uses a special catheter or tube to deliver low-power and low-temperature radiofrequency energy to the muscle tissues in the LOS. This remodels the muscle tissue, strengthening it to prevent the reflux occurring.

How is the procedure carried out?

Unlike conventional surgery, Stretta Therapy does not require any incisions, stitches or implants. Under sedation, a tube that is inserted through the mouth and down the throat places small needles into the muscle of the LOS valve. This delivers several radiofrequency waves to the muscle, warming the tissue. The procedure takes approximately 60 minutes to perform and patients can return to normal activities the following day.

Where is it available?

In the UK, Stretta therapy was approved by NICE (National Institute for Health and Care Excellence) and in 2014 the James Cook University Hospital in Middlesbrough became the first hospital to offer Stretta to NHS patients. There are also five Stretta centres throughout the UK in London, Glasgow, Manchester, Birmingham and Bristol.

How effective is it?

According to Mederi Therapeutics, which manufacturers Stretta devices, 37 studies from five continents have demonstrated that Stretta is effective and safe, with the lowest reported complication rate of any non-drug option for reflux disease. Clinical studies have shown Stretta Therapy helps reduce incidents of LOS relaxation and increases the valve’s thickness due to muscle growth and the sphincter getting thicker and stronger, reducing spontaneous reflux. A 10-year patient follow-up yielded high patient satisfaction scores, a reduced need for medication and no serious adverse effects.

Are there any issues or disadvantages?

Following Stretta therapy, there may be pain in the chest or upper abdomen but this typically improves in three to five days.

According to Stretta research, patients who are not considered good candidates for the Stretta procedure include those patients with a greater than 2cm long hiatal hernia, patients who have significant dysphagia, patients who have grade C or D oesophagitis and patients who have inadequate oesophageal peristalsis and incomplete LES relaxation with swallowing.