Dr. Gary Reiss: The new frontier in GERD & Barrett's esophagus treatment

Gastroesophageal reflux disease and Barrett's esophagus are two conditions frequently seen in the GI field, but new advances are changing the way gastroenterologists approach patient treatment.

Gary Reiss, MD, Louisiana State University Health Sciences Center (New Orleans): For too long, we have been scoping GERD patients without fixing the problem. At best, we would treat the complications of GERD in our ASC with either endoscopic mucosal resection or HALO radiofrequency ablation of early cancer and Barrett's esophagus. 

Now, however, there are a variety of devices available to correct the underlying lower esophageal sphincter defect that drives most reflux disease.  Options include non-ablative radiofrequency treatment of the lower esophageal sphincter to induce remodeling and regeneration of a damaged sphincter (the Stretta procedure) as well as devices that seek to endoscopically recreate a fundoplication, such as the TIF procedure and the MUSE system.  Surgical devices to create an additional reflux barrier, such as the LINX device, are also available. 

The introduction of Stretta into our ASC has been particularly beneficial to patients and to our practice. It is a good fit for our endoscopy-only ASC in terms of ease of use, room turn-around time, reimbursement, and patient safety profile.  Because it has an established track record of almost 20,000 procedures and published data showing 10 year durability, we feel comfortable that we are providing a good solution to our patients with chronic GERD.  With this, and the other options available, we can now do significantly more than just scope our GERD patients and treat the complications; we can cure the disease.

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