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A n n u a l E u r o p e a n C o n f e r e n c e o n
Gastroenterology
Euro Gastro 2018
J u n e 1 9 - 2 0 , 2 0 1 8
P a r i s , F r a n c e
Page 47
Journal of Clinical Gastroenterology and Hepatology
ISSN 2575-7733
Background:
Gastroesophageal reflux disease (GORD) is one of the leading gastrointestinal disorders. Patients with GORD often seek
alternative therapy for inadequate symptom control, with over 40 % not responding to medical treatment. Current treatments include
lifestyle modifications, pharmacological therapies, surgical and STRETTA therapy that is a minimally invasive procedure that significantly
reduces GORD symptoms, allowing the majority of patients to eliminate or decrease use of proton pump inhibitors (PPIs)
Methods & Patients:
A multi-center retrospective data collected from three Mediclinic Middle East centers in Dubai, UAE on (75) patients
during Jan 2015-Nov 2017. Most patients evaluated had ambulatory 24-hour pH testing & previous gastroscopy for assessment of
LOS.3 patients had previous nissan fundoplication surgery and one had previous gastric bypass. Stretta uses radiofrequency (RF) energy
delivered to the tissues of the distal lower oesophageal sphincter (LOS) and gastric cardia, which decreases LOS compliance, increases
LOS muscle mass, and limits the inappropriate transient LOS relaxations responsible for GORD. Patients were followed up 2 weeks, 30
days, 3 months and one year
Results:
In the prior DeMeester score average of 99 with hypotensive LOS pressure, there was a small learning curve (45+/-7) min for
the first 10 procedures; mild to moderate pain during the first 72 postoperative hours was controlled with paracetamol syrup. Two (2.5%)
complications; one patient presented with ulcerative esophagitis 7 days after the Stretta treatment, and one patient developed pneumonia
5 days postoperatively. 50 patients (63%) were 50% on reduced PPI dose at two months and 61 patients (77%) were off treatment at 6
months and 70 patients (88%) at 12 months were off all antisecretory medication. The other five patients (6%) were on PRN PPI
Conclusion:
In our study 88% of patients were off PPIs at one year. The rising concern of long-term side effects of the popular proton-
pump inhibitors have prompted reinterest in endoscopic procedures for GORD and also economic significance as the costs of long-
term pharmacological treatment are tremendous. STRETTA delivery significantly improved GORD symptoms with high efficacy and low
complication rate endoscopic procedure. This procedure represents an excellent alternative for selected symptomatic gastroesophageal
reflux disease patients who are intolerant of/or desire an alternative to, traditional medical therapies.
Biography
Mazin Aljabiri, Fellow of the Royal college of Physicians of London, UK. He has recently relocated to Dubai from UK and joined Mediclinic
Group (Dubai Mall and Mediclinic City Hospital) as a Consultant Physician and Gastroenterologist and Lead Gastroenterologist at MDM. He
became a member of the Royal College of physicians, London, Glasgow and Edinburgh in 2004. He had obtained his CCST in 2010 and he
became a Fellow for the Royal college of London in 2012. He is JAG accredited in Therapeutic Endoscopy and he has an expertise in Bowel
Cancer Screening since 2011. He had been on several trainings course to Japan and he is accredited for EMR/ EPMR and ESD. He has taken
several posts as an IBD Lead and Endoscopy Lead.
Mazin.aljabiri@gmail.comContemporary STRETTA therapy for gastroesophageal reflux disease
in the modern-day era of the hyped PPI concerns, friend or foe?
Aljabiri M
1,3
, Shamsheer K
3
,Rathore O
2
,Mediodia
1,3
, Pradeep A
4
, Santos
A
1,3
, Daulat E
4
, Villarnanda C
4
, Rabon D
4
, Ipo L
2
, Concepcion M
4
, Villanueva
J
1,3
, Lazaro T
1,3
, Balizario A
2
, George G
1,3
, Devassy S
4
,Eslim A
1,3
, Suralal A
2
, Kahlenberg A
1,3
, Gattner H
1,3
, McCombe K
1,3
, Mordani K
1,3
, Abdulla M
1,3
,
Aboukofa M
1,3
, Bertin M
1,3
, Sherllalah S
1,3
and Nesnas Z
1,3
1
Mediclinic City Hospital, UAE
2
Mediclinic Welcare Hospital, UAE
3
Mediclinic Dubai Mall, UAE
Aljabiri M et al., J Clin Gastroenterol Hepatol 2018, Volume: 2
DOI: 10.21767/2575-7733-C1-002