Research has found that patients with Gastro Oesophageal Reflux (GORD), which is an extremely common condition, can have



a worse quality of life than some patients with angina, peptic ulcer disease, congestive heart failure or menopausal symptoms. The combination of symptoms, dietary restrictions and functional limitations can take a toll on overall sense of well-being. Although a number of drugs can be effective to manage the condition, a substantial proportion of patients do not respond to treatment or they may be 'partial responders' requiring increasing doses of drugs. Many of these patients also require life-long treatment which is expensive and can cause problems. Several techniques for the treatment of GORD have been tested over the past few years. However, only one of them, called the 'Stretta procedure' has withstood the test of time.

What exactly is Gastro Oesophageal Reflux?

Gastro Esophageal Reflux Disease (GERD) is the movement of acid from the stomach back up into the food pipe (oesophagus). It may be erosive, that is it may cause inflammation or even ulceration, or else it may be a nonerosive reflux disease (NERD). In the latter case, the acid will not cause inflammation of the oesophagus but may still cause symptoms.

What are the symptoms of GERD?

The symptoms of GERD are usually those of heartburn, bloating and sometimes pain in the stomach area. Symptoms tend to occur after heavy or fatty meals and may also occur at night or on bending down.

Approximately how many people suffer from it?

Up to 10% of the world population have heartburn daily, and 44% have symptoms at least once a month.

What are the most common treatments of Gastro Oesophageal Reflux?

There is a whole spectrum of symptoms of GERD, ranging from the very mild to the severely incapacitating. Treatment depends on the severity of symptoms and may range from simple antacids to stronger agents that prevent or decrease the production.

Is the Stretta system considered as the best procedure?

The Stretta procedure is useful in patients with severe symptoms who are unable or unwilling to remain on life-long medication. It is a very safe procedure that is carried out through the mouth (enscopically) without any open surgery. Patients come in, have the procedure and are discharged within a few hours. There is a very good response rate to the Stretta and most patients are able to stop their medications completely.

How is the Stretta procedure performed?

The Stretta device is a thin tube, or catheter, with a balloon at the end. With the patient conscious but under heavy sedation, the catheter is guided through the endoscope which is placed in the oesophagus just above the stomach. There the balloon is inflated, exposing four sharp probes on the outside of the balloon. The probes then discharge high-frequency radio waves into the lower oesophageal sphincter (LES). This procedure is repeated at several levels above and below the lower end of the oesophagus. Total procedure time is approximately 45 minutes.

The Right Foods

Foods that are well known to trigger heartburn such as fats, oils, chocolate or citrus products can be less tempting when there's a supply of 'safe' ingredients in your kitchen cabinets, so if you suffer from heartburn shop wisely while at the supermarket.

Grains - Try to purchase whole grains against refined grains whenever possible.

Pasta - Be sure to prepare with a light sauce (not tomato-based or high-fat). Perk up the dish with herbs like basil and tarragon.

Beans, peas and lentils - All these items provide a good source of vegetable protein, B-vitamins, and minerals such as calcium and iron. They

are also an excellent source of fibre. Experiment with red kidney beans, black beans, white kidney beans and split peas.

Oils - Use in moderation. The darker oils (like sesame) have wonderful flavour, and a little goes a long way in adding good taste and enjoyment tc dishes.

Vinegars - These can be problem items for severe heartburn sufferers because of the acid content. However, cider vinegar and rice vinegar are often tolerated better by many people, and both add nice flavour to food.

Spices - several spices are generally irritating to the stomach lining and are especially troublesome for heartburn sufferers. These include black pepper, mint, crushed red pepper flakes, cloves, tabasco sauce, mustard seeds, chili powder, nutmeg and curry.

MORE ON THE STRETTA PROCEDURE:

The Stretta Procedure is an essentially non-invasive, one-time treatment that involves no cutting or sewing and leaves no skin incisions or scars. It can be performed as an outpatient in the day ward.

Compared to laparoscopic surgery, Stretta is a much less invasive out-patient procedure.

Because Stretta is less invasive it has less sideeffects. Side effects are very rare and usually transient. These include transient fever, dysphagia, chest pain, superficial mucosal injury and anesthesia reactions.

The procedure is very safe when carried out by a trained gastroenterologist.

Patients who have difficulties taking medications or do not wish to take medications for the rest of their lives may benefit from the procedure. Patients who do not respond to stomach acid reducing medications may also benefit from the Stretta procedure.

Most studies show that the Stretta procedure is effective in 75 to 85% of cases.

The entire procedure is less than an hour long and does not require overnight hospitalisation. Most patients resume their normal activities the next day.

The Stretta procedure has been performed successfully on nearly 12,000 patients.

Studies show that 90% of patients who have received the Stretta procedure would recommend it to a friend.

More than five years of clinical studies have shown that after the Stretta procedure there is a significant improvement in quality of life; with sustainable improvement of GERD symptoms along with less dependence on stomach acid reducing medications.

acid within the stomach, such as omeprazole or rabeprazole. In severe cases which do not respond or are intolerant to medical treatrnent, the Stretta procedure may be performed on the patient.