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  • Endoscopic day case antireflux radiofrequency (Stretta) therapy improves quality of life and reduce proton pump inhibitor (PPI) dependency in patients with gastro-oesophageal reflux disease: a prospective study from a UK tertiary centre

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Endoscopy
Original article
Endoscopic day case antireflux radiofrequency (Stretta) therapy improves quality of life and reduce proton pump inhibitor (PPI) dependency in patients with gastro-oesophageal reflux disease: a prospective study from a UK tertiary centre
  1. YKS Viswanath Mr1,
  2. Nicola Maguire1,
  3. Reece-Bolton Obuobi1,
  4. Anjan Dhar2,
  5. Siby Punnoose2,3
  1. 1 Upper GI Laparoscopic and endoscopic surgery, James Cook University Hospital, Middlesbrough, Cleveland, UK
  2. 2 Darlington Memorial Hospital, Bishop Auckland, UK
  3. 3 Gastroenterology, County Durham & Darlington NHS FoundationTrust
  1. Correspondence to Mr YKS Viswanath Mr, James Cook University Hospital, Middlesbrough TS4 3BW, UK; keyhole1234{at}gmail.com

Abstract

Background Endoscopic antireflux radiofrequency treatment (Stretta) offers a therapeutic alternative for patients suffering from refractory gastro-oesophageal reflux disease (GORD). Current evidence suggests that the treatment may improve symptoms of GORD and decrease requirement for proton pump inhibitor (PPI) therapy.

Methods Prospective assessment of patients undergoing Stretta, between October 2014 and February 2016, in a UK tertiary referral centre was carried. All patients were assessed for suitability using endoscopy, contrast studies, and pH and manometry studies. The Gastro-oesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) was used to evaluate symptoms along with PPI dependency, pre-Stretta and post-Stretta treatment. Patients were followed up by outpatient clinic appointment and telephone consultation.

Results Fifty consecutive patients were followed up for a median of 771 days (range 499–1162) following treatment with Stretta. The average GERD-HRQL score improved from 46.2/75 (±14.2) preprocedure to 15.2/75 (±17.3) postprocedure. Dissatisfaction with GORD as measured in the GERD-HRQL decreased from 100% to 10% with three patients showing no improvement (non-responders) at follow up and two late failures at the time of this review. There were no complications and all cases were carried out as day cases.

Conclusion There are currently few effective therapeutic alternatives to antireflux surgery for refractory GORD. This series corroborates the value and safety of Stretta as a viable option for selected patients who are unwilling or unable to undergo an operation. Stretta improves quality of life and decreases PPI dependency in selected patients with GORD.

  • endoscopic procedures
  • gastroesophageal reflux disease
  • hiatal hernia
  • oesophageal sphincter

https://doi.org/10.1136/flgastro-2018-101028

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    Footnotes

    • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. YKSV: involved in planning, drafting, editing and submitting the manuscript. NM: drafting and data analysis. R-BO: data collection and telephone assessment. AD: assisted in planning and advised towards preparation of manuscript. SP: data collection and data analysis.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement NA.

    • Author note All authors confirm that this work ‘conform to the guidelines set forth in the Helsinki Declaration of 1975, as revised in 2000, concerning human and Animal Rights, and that they followed the policy concerning Informed Consent’. The data analysed in this article are anonymised without any patient identifiable information.