Stretta procedure versus proton pump inhibitors for the treatment of nonerosive reflux disease

Abstract

To compare the Stretta procedure with proton pump inhibitors for the treatment of nonerosive reflux disease (NERD). From July 2018 to April 2019, patients diagnosed with NERD and referred for treatment were enrolled. They were treated with either Stretta procedure or proton pump inhibitor (PPI) medication and followed-up for 6 months. The symptom control, quality of life, lower esophageal sphincter (LES) pressure, 24-hour pH parameters, PPI usage and satisfaction rate were evaluated. The complications were assessed. The outcomes of the 2 groups were analyzed and compared. Twenty-eight patients in the Stretta group and 21 patients in the PPI group completed the 6-month follow-up. No severe adverse events occurred in both groups. Both interventions were effective in improvement of symptom and quality of life. The symptom score improvement was significantly superior in the Stretta group compared to the PPI group (6.3 ± 3.4 vs 8.5 ± 4.1, P = .03). LES pressure increased significantly in the Stretta group compared to the PPI group (14.2 ± 4.4 mm Hg vs 10.0 ± 4.0 mm Hg, P < .01). Although both interventions improved 24-hour pH parameters, including number of acid episodes (P = .27), acid exposure time (P = .39), and DeMeester score (P = .28), no difference was found between the 2 groups. Complete PPI cessation rate (82% vs 52%, P = .03) as well as satisfaction rate (89% vs 57%, P = .02) was much higher in Stretta group than those in the PPI group The Stretta procedure was safe and effective in the short term for the management of NERD. The Stretta procedure resulted in higher LES pressure and achieved better improvement of symptom control and PPI cessation than did PPI in the short term.

Is patient satisfaction sufficient to validate endoscopic anti-reflux treatments?

“…Also in the study of He et al [ 5 ], the symptom score improvement was significantly higher in the STRETTA group of 26 patients compared with the PPI group of 21 patients after 6 mo, whereas both interventions improved, without significant differences, the 24 h pH parameters, including the number of acid episodes, acid exposure time, and DeMeester score.…”

Clinical efficacy of endoscopic antireflux mucosectomy vs. Stretta radiofrequency in the treatment of gastroesophageal reflux disease: a retrospective, single-center cohort study

“…SRF (13): first, upper gastrointestinal endoscopy was performed to confirm the location and depth of the squamocolumnar junction (SCJ). The endoscope was then removed, and the Stretta catheter was positioned 1 cm above the SCJ according to the distance previously determined.…”

Novel/Multidisciplinary Approach in Treating Morbidly Obese Patients with GERD

“…Moreover, data demonstrated that it carries more adverse events like dysphagia, abdominal distension, diarrhea, chronic stomach pain and recurrence of GERD when compared to other endoscopic approaches. However, when compared to PPI use alone, it shows superior outcomes 37…”