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A NOVEL MODALITY FOR THE TREATMENT OF ACID REFLUX
GASTROESOPHAGEAL REFLUX DISEASE (GERD)
GERD (gastroesophageal reflux disease) is when stomach contents “reflux” upward from the stomach into the esophagus through the lower esophageal sphincter (LES). Normally, the LES acts as a one-way valve, enabling food to pass downward into the stomach but not upward into the esophagus. Chronic exposure to refluxed material such as, stomach acid, enzymes and bile causes irritation of the esophagus that can result in inflammation (esophagitis), ulceration and pain.
GERD can cause a wide range of symptoms
• Persistent heartburn
• Choking episodes at night
• Chest pain
• Difficulty or pain when swallowing
• Chronic sore throat or cough
A visit to Dr. Fadi Diab, is the best way to determine whether one has GERD.
Treatment options for GERD often depend on the severity of the condition and may include the following:
Changes in lifestyle may relieve GERD 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
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
- H2-receptor antagonists
This surgery involves wrapping the stomach around the esophagus to improve the barrier function of the lower esophageal sphincter.
• 2-4 hour procedure
• General anesthesia
• 1-4 day hospital stay
• 1-3 weeks back to work
THE STRETTA PROCEDURE:
Stretta is an effective outpatient procedure for patients who prefer a less invasive therapy.
• 45 minute procedure
• Outpatient, no hospital stay
• 1-2 days 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 for you.
The good news is that STRETTA is now available in Jordan! Dr. Fadi Diab has done specialized training on this procedure and is currently performing it in his practice!
Stretta Therapy is a minimally invasive, outpatient procedure that takes approximately 60 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 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.
A specially designed, flexible, catheter is passed through the mouth, into the esophagus, and is positioned at the LES valve near the stomach. The catheter places 4 small needles into the muscle of the LES and delivers RF to the muscle, thereby warming the tissue to 85° Celsius (185° Fahrenheit). Several areas in the region of the LES and stomach are treated.
POSITION OF RADIOFREQUENCY CATHETER AT GASTROESOPHAGEAL SPHINCTER
The Stretta procedure utilizes radiofrequency energy (RF), an energy waveform which is used in many medical specialties for coagulating or treating tissues. RF is used by Cardiologists to stop dangerous heart rhythms. Urologists use RF for treating prostate enlargement (difficulty passing urine in males). Ear, nose, and throat specialists use RF to eliminate snoring and sleep apnea (stoppage of breathing during sleep). General surgeons use RF to cut and coagulate tissue. RF has been used in surgery for nearly 100 years. The Stretta procedure was cleared by the FDA for the treatment of GERD in April 2000, and uses RF to tighten the valve between the stomach and the esophagus which has been proven to reduce GERD symptoms.
Human tissue responds to the warming effect of RF by contracting. A portion of the contraction takes place immediately at the time of treatment while the remainder takes place as the body heals over the ensuing 6-12 months. GERD symptoms may take several months to be reduced and some patients may require anti-secretory medication for several months after treatment.
In clinical trials evaluating the Stretta procedure over 75% of patients experienced a positive response to treatment. Studies have shown a significant improvement in GERD symptom scores for heartburn, patient satisfaction, and quality of life. In many cases Stretta has eliminated or decreased the need for medication and these results are sustained over 4 years of follow-up. Any side effects of Stretta are less than those associated with surgery and patients that fail to improve after this treatment may go on to have surgery at a later date.
Frequently Asked Questions:
What can I expect in terms of my recovery after the Stretta Procedure?
Patients are advised to restrict their diet to liquids for 24 hours after the procedure, followed by a soft diet for the next 7 days. Most patients are able to return to normal activities the following day.
Will I experience any pain during or after the Stretta Procedure?
Some patients experience mild chest or abdominal discomfort during the procedure, which may be alleviated with additional sedation medications. In the days following the procedure, patients may feel tenderness in the chest or upper abdomen, which typically improves in 3 to 5 days.
How soon will I experience improvement after the Stretta Procedure?
Patients typically remain on their GERD medications for 8 weeks follo
wing the procedure. After this period, your physician may discontinue or reduce your medication according to your symptom response to the procedure.
The Stretta Procedure is currently available at our center in Amman, Jordan.
Dr. Fadi Diab has done specialized training on this procedure and is currently performing it in his practice.
Call Dr. Fadi Diab for any inquiries regarding the Stretta Procedure.