Anyone familiar with the Stretta procedure for curing reflux?

I'm looking to collect patient experiences of oesophageal procedures that may help future patients.

Some context on me: I'm 99% sure I'm having the Stretta performed this June (it's scheduled for the 10th), so I will keep you posted on how that goes as well. 

The past few days I was just trying to rule out any possibility of nerve pain causing this throat pain, which so far, has been disproven - I've had an x-ray, a CT scan and an upcoming MRI, and everything looks perfect; and I've been to a very experienced neurologist and he doesn't seem to think it's nerve pain - but gave me an antidepressant/nerve pain medication to try out, to see if it helps even a little. I took it for one day, and it actually made the throat pain worse! and just weirded me out altogether. So it's unlikely this is nerve-related, and based on symptoms and all my other tests, I'm pretty sure I have LPR. I'll be having a few more tests just before my Stretta to re-comfirm, but now it's almost a 100% caused by reflux, and Stretta is the ideal treatment for me at this point.

I believe carafates are supposed to help post-Stretta, and of course liquids are recommended for the period immediately after. 

As my stomach does not close medication has little effect. The gas riseing from my stomach is breathed into my airway. This has caused much coughing and irritation.

I have chosen not to have surgery because of potential complications. Stretta is less invasive and I look forward to it being a great success. I will continue to eat healthy diet to help the treatment to continue to be successful. Diet it important to maintain a healthy body.

Sounds as if your problems are reflux (mechnical) rather than acid (chemical) which drugs aren't so effective for - they just make the reflux less harmful. You may be one of the 41% who can remain off medication.

Interested to know where you're having it done. I'm assuming not on NHS? (I know this is something a group is discussing presently and I know one of the new surgeons at our local hospital is accreddited to do it. )

Healthy diet is important but it cannot cure a malfunctioning lower oesophageal sphincter.

Just to add the acid does rise and causes regurgitation. I got that more under control with illiminating certain foods and having to eat smaller portions. But because the stomach does not close, when eating, the food just piles up into my esophagus.

Example: I have just had small slice of brown bread and cup of tea. My stomach is very uncomfortable and I can feel the sensation all the way up to my throat.

If  !! I have one or two rich tea biscuits, I am in real trouble with my throat, breathing with wheeze and coughing/choking. Very embarrassing in company.

It seems now that any food or liquid, causes discomfort.

It's been in these last 7 months that I've had this constant throat pain (which i believe was triggered by an excess of stress, green tea, acidic foods and over exercising) and have traced it to LPR. But it's not the kind of situation that warrants immediate surgery and other risks, but PPIs don't help at ALL, so as you say: Stretta represents the ideal mid-way solution.

Thanks again for replying! If you like, I can let you know how my Stretta goes (it's almost official I'm having one now.)

Perhaps in private message also, if that will help.

Hi ElizabethG did you have the Stretta performed with any success in your symptoms? If so what was your experience? I'm in the U.S. and considering the Stretta. I have severe LPR

I posted this by mistake to another member. ;-(  

Hi Barrets,

As you may know my GI said I have mild barrets.  Put me PPI's and sent me home- He said surgery is not an option for me right now.  He also said barrets is reversible.

As you may know I have no reflux symptoms besides moderate bloating sometimes, sphincter is working fine and normal acid levels.  Gi said it may be bile reflux because my gall-blatter was removed 18 months ago.   I do have chest pain, rib-cage pain and lack of air which GI said is not related to barrets.

I'm considering a stretta therapy with another GI  and will like to know your opinion on this.  Based on some Doctors and studies PPI's are not helping with barrets and in my case I really see no use if I have no other symptom.   I eat healthy and don't have much stress besides the pain.

Any opinion is appreciated ;-)  God Bless!

It used to be thought that Barrett's was reversible but since about 2008 and better understanding of the propagation of DNA mutations it is now considered not to be reversible asince there is no mechanism to undo a mutation.

For Barrett's to develop there must have always been bile refluxing along with the acid.

"Bile Acid at Low pH Reduces Squamous Differentiation and Activates EGFR Signaling in Esophageal Squamous Cells in 3-D Culture." (Ghatak et al University of Rochester Oct 2013) 

"Results suggest that bile at low pH, but not bile or low pH alone, promotes loss of differentiation status of stratified squamous esophageal epithelium in vitro, possibly by initiating a mucosal repair response through epidermal growth factor activation." (Journal of Gastrointestinal Surgery)

When I was writing the Down With Acid book, Mederi Therapeutics,who manufacture Stretta, provided me with this statement:

"We do not position Stretta as competitive treatment with surgery – but instead a less invasive bridge that allows some patients for whom medications are not completely effective to avoid surgery and its potential complications, or if someone has had surgery allows them an option other than additional surgery."

I thought  these statistics were pretty poor: "72 % of patients normalizing GERD symptom scores, 41 % of patients able to remain off regular medication for GERD, 64 % of patients able to reduce medication use by 50 % or greater, and more than 60 % sustained improvement in satisfaction."

PPIs are excellent at their one job - to reduce acid. Thhey will not reduce reflux nor cure your Barrett's. Your symptoms are most likely due to reflux. Barrett's has no symptoms and is a result of reflux ( + acid, + bile ) rather than being a causal agent.

Reflux isn't caused by acid. You only get reflux if your sphincter isn't working properly.

Acidity of foods maks no differene to reflux.

Barrett's is unlikely to progress. Instead of asking how to prevent it progressing, the real question is to identify why it does progress in a very small number of cass.

So how is Barrets possible in my case if my sphincter is working fine (manometry) ?  Plus, I just had barium swallow and again no reflux, no nothing on both barium swallows.  

Based on D Koosman, acidity is important if you have silent reflux.

Right, only 0.5% gets it. 1 out of 200 and that is why science is not concerned about this problem.   Knowing what caused the problem for them, will give me the answer to prevent it from progressing. So in a way is the same question. ;-)

I guess my best option for now is to deal with my gastritis which will prevent further damage to my esophagus.

Jose

God Bless!

The fact you have Barrett's proves your sphincter hasn't always worked properly - and presumably still doesn't if you have silent reflux.

"Silent Reflux" is one of th emany terms coined by Jamie Kaufman to refer to what is properly called extra-oesophageal reflux

Reflux starts from the stomach via the lower oesophageal sphincter to the oesophagus and continues full column where it breaches the upper sphincter.

I don't know D Koosman but it is important to reduce the acid so the reflux is less acidic which s why acid suppressant medication is prescribed. Acidity of foods makes no difference. Stomach acid is controlled from the brain:

There are three regulatory molecules that stimulate acid secretion (acetylcholine, histamine,gastrin) and one regulatory molecule that inhibits acid secretion (somatostatin). Acetylcholineis a neurotransmitter that is released by enteric neurons. Histamine is a paracrine that is released from ECL (enterochromaffin-like) cells. Gastrin is a hormone that is released by G cells, endocrine cells that are located in the gastric epithelium. Somatostatin is also secreted by endocrine cells of the gastric epithelium; it can act as either a paracrine or a hormone.

I don't know where you get your figure of only 0.5% having silent reflux. I have just repeated a survey initially carried out and presented as a paper 3 years ago which shows out of acid refluxers 70% experience some symptoms of extra-oesophageal reflux. The survey admitedly was done with Barrett's Oesophagus patients who probably make up 5% of the population, which would indicate 3.5% have extra-oesophageal reflux.

Reducing stomach acid is important to permit your gastritis to heal but it won't affect your reflux.

You will find some (mainly otolaryngologists) who only consider acid at the throat but when it comes to reflux (and gastritis) , you need to consult a gastroenterologist.

Anything is possible, that is why I do not  trust 100% medications, surgeries or procedures.   But I have to live with it!  jejejej

No, not the silent reflux.  Every 1 in 200 the Barrets escalate to cancer so is very uncommon like you said. 

I believe my problem is bile, which I got thanks to the removal of my gall-bladder. So basically I'm stock with a poblem and no conclusive answer because bile can't be treated like regular reflux and that is why my acid levels are normal and PPI's do not help.  Now, I have to disagree with my GI when he said my reflux ( which he said it may be bile) is not the reason for my chest/rib-cage pain and lack of air.  I completely disagree! I'm going to get copies of everything and get a 3rd opinion. Now, based on this what I need to know is how to deal with bile, whihc their is not real answer for now. ;-(  Thanks God my stomach is not in pain and never has been and never will. ;-)  

Btw, Dr Koofman, leader ENT specialist in silent reflux. She is all around you tube.

Thanks for the info Barrets!

Jose

God Bless!

I've referred to Jamie Kaufman many times previously.

She is an otolaryngologist. ie she specialises in the throat and knows acid there is bad news. However she is not a gastroenterologist and pays little heed as to where the acid actually originates. It comes up from the stomach. Acid foods and drinks make no difference to acid hypersectretion.

She has made a name for herself. Some of her activity I applaud. She has rasied awareness of the dangers of extra-oesophageal reflux which she has chosen to rename as "Silent Reflux", "LaryngoPharyngeal Reflux (LPR)", " Respiratory Reflux" etc. She also repeats the useful lifestyle messages about leaving tim ebetween your last meal and going to bed etc.

However, some of what she says is not based on fact but on repeated anecdotal myth and some of what she says is also potentially dangerous. eg her promotion of alaline water which is a hoax perpetrated by the bottled water industry with many stuudies showing it has no value but just one (written by a certain Dr Kaufman J but without peer-review) that suggests it is beneficial.

It seems that, like so many others, she has decided it's more lucrative selling myth.

Visit any of her websites and you'll see they are just advertisements for her overpriced books. This is one reason the "definitive guide to the subject" Down With Acid encyclopaedia is FREE!

Hi Tyra

do you mind me asking if you had your Stretta done ? If so I'm hoping you'll tell me how you're doing as I too have silent reflux and have been avoiding the dreaded Nissan fundoplication for three yrs now. Struggling at the moment so hoping I'm a candidate for a stretta but was diagnosed with reflux and 2cm hernia 3 yrs ago so not sure if I'm a suitable candidate or not.

Thanks Helen