Radiofrequency treatment for gastroesophageal reflux disease
- George Triadafilopoulos, MD
George Triadafilopoulos, MD
- Clinical Professor of Medicine
- Stanford University School of Medicine
Standard therapy for gastroesophageal reflux disease (GERD) involves behavioral modifications and treatment with medications that reduce acid production or improve esophageal motility. Open or laparoscopic Nissen fundoplication may be chosen for those patients who do not wish to remain on an antisecretory medication, have an inadequate response to antisecretory medication, have a large hiatal hernia, or have persistence of esophagitis on medication. Esophagitis and GERD symptoms are improved or resolved after fundoplication in 76 to 98 percent of patients, while esophageal acid exposure time is normalized in approximately 90 percent of patients. (See "Surgical management of gastroesophageal reflux in adults".)
Minimally invasive alternatives to standard antireflux surgery have been developed, and include :
●Plication of tissues in the lower esophageal region with sutures, transmural fasteners, or staples that are placed during endoscopy (EndoCinch, EsophyX) .
●Injection of a biopolymer into the lower esophageal sphincter (Enteryx). However, the procedure has been associated with severe complications, including pneumomediastinum, embolization of the polymer leading to renal failure, esophageal stenosis, and a death due to intra-aortic injection of the polymer. Because of these complications it was recalled in 2005.
●Application of controlled radiofrequency (RF) energy to the lower esophageal sphincter region (Stretta procedure). An advantage of RF treatment is that it can be used in patients with challenging anatomy .
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