Stretta Procedure Improves GERD Symptoms, Reduces Need for PPIs Interview with:

Dr. Ronnie Fass, MD Professor, School of Medicine Case Western Reserve University

Dr. Ronnie Fass

Dr. Ronnie Fass, MD
Professor, School of Medicine
Case Western Reserve University What is the background for this study?

Response: The endoscopic radiofrequency procedure (Stretta) has been used for more than a decade to treat patients with gastroesophageal reflux disease (GERD). Over time, there were several Meta-analyses with variable designs of the Stretta procedure providing conflicting results. Thus, the purpose of the current systematic review and meta-analysis was to determine the efficacy of the Stretta procedure using all currently available controlled and cohort studies. What are the main findings?

Response: The Stretta procedure significantly reduces the use of proton pump inhibitors, while improving esophageal acid exposure time, heartburn symptoms and health related quality of life. There was a 36% reduction in erosive esophagitis incidence. There was no significant effect on LES basal pressure. What should readers take away from your report?

Response: The meta-analysis of currently available 28 therapeutic studies, representing 2,468 patients, suggests that the Stretta procedure significantly improves subjective and objective clinical endpoints and therefore should be considered as a viable alternative treatment in the management of GERD. What recommendations do you have for future research as a result of this study?

Response: The study demonstrated the value of the Stretta procedure in regular GERD patients. However, future research should assess the possible role of positioning the Stretta procedure in other, less common but still important, clinical scenarios. For example, the value of the Stretta procedure in patients undergoing the sleeve procedure for morbid obesity. This type of bariatric surgery has been shown to increase patients risk for GERD. Other opportunities include, the role of the Stretta procedure in patients undergoing per-oral endoscopic myotomy (POEM) for achalasia, those who failed surgical fundoplication, patients with ineffective esophageal motility, Laryngopharyngeal reflux (LPR) sufferers, and those with Barrett’s esophagus. Is there anything else you would like to add?

Response: The strength of our study is the inclusion of both randomized controlled trials (RCT’s) and cohort studies. The input of the latter studies provides a unique opportunity to assess the longitudinal effect of the Stretta procedure.

Disclosures: I am serving as a consultant to Mederi Therapeutics Thank you for your contribution to the community.


Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease.
Fass R1, Cahn F2, Scotti DJ3, Gregory DA4.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 11, 2017 by Marie Benz MD FAAD

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