It’s a critical time for patients who suffer from Gastroesophageal Reflux Disease (GERD). PPI therapy, which has been the standard of care for the last decade, has come under increased scrutiny. New studies have shown significant risks of long-term PPI therapy, and patients need to decide whether to accept the risk, or explore other options to resolve their symptoms. The good news for patients is that there are options, and they run the gamut from RF energy treatment, to implants, to surgery.

STRETTA THERAPY – Radiofrequency Energy

Stretta RF Therapy offers an option to PPIs. Without Stretta, patients have only invasive options like surgery or implants. Stretta therapy involves low-temperature radiofrequency (RF) energy delivered to the muscle of the LES and Gastric Cardia in an out-patient setting. Stretta is also a good option for patients who have non-acid reflux.

Studies of Stretta Therapy show that Stretta remodels the lower esophageal sphincter (LES). More than 33 studies show long-term elimination or significant reduction of symptoms (up to 10 years). Studies also show the following:
– Increased muscle wall thickness
– Decreased tissue compliance
– Decreased random LES relaxations

The cost of Stretta is significantly lower than other options, and seems the logical choice when reviewing the safety profile and long history of effectiveness. Additionally, Stretta doesn’t burn any bridges. All other treatments remain an option after Stretta Therapy.

LINX – Magnetic implant

Linx was recently FDA approved and shows interesting results. Significantly higher cost, surgery required to implant the device, and the inability to have a standard MRI after Linx implantation, may be a barrier for patients and facilities.

Esophyx – Transoral Incisionless Fundoplication (anatomic correction)

The TIF procedure emulates a partial fundoplication, but is less invasive, allowing physicians to wrap a section of the stomach around the esophagus and staple it, through an existing orifice.

Nissen Fundoplication Surgery (anatomic correction)

A Nissen is considered the standard surgical approach for treatment of severe GERD. This can be done laparosopically and involves wrapping a section of the stomach around the esophagus. This is a good option for more severe GERD and when patients have a larger hiatal hernia.

It is important for patients to have a discussion with their doctor about all available therapies to determine what is the best option for their level of GERD.