Stretta therapy in the management of gastroesophageal reflux disease (GERD)

Dalbir S. Sandhu, Ronnie Fass


Treatment of gastroesophageal reflux disease (GERD) includes medical, surgical, and endoscopic intervention. The growing concerns of patients and physicians alike about adverse effects of chronic proton pump inhibitor (PPI) therapy or anti-reflux surgery have positioned endoscopic therapy for GERD on par with other therapeutic interventions. Endoscopic radiofrequency (RF) ablation (Stretta) has been used for more than 15 years and it is the most studied and followed endoscopic procedure for GERD. The technique itself has improved over the years and has been shown to be effective, safe and durable. Several meta-analyses and cohort studies have cemented the efficacy of the technique in improving patients’ health related quality of life, GERD symptoms, PPI consumption and esophageal acid exposure over more than 10 years follow up. Presently, endoscopic RF has been integrated into treatment guidelines of patients with GERD with diverse clinical scenarios.