GERD / heartburn is a common condition faced by many. The symptoms vary from being managed with lifestyle modifications and medications, to severe symptoms that affecting work and quality of life. GERD can also present with atypical symptoms like asthma (due to recurrent microaspirations), dental caries , bad breadth and abdominal pain. Based on the symptoms, the patient’s general health and endoscopic findings, the doctor will advice accordingly.
AntiReflux Mucosal Ablation (ARMA) and Antireflux mucosectomy (ARMS) are new interventions that can be carried out using an endoscope inserted via the mouth.
In this procedure, the endoscopist will evaluate the lower esophageal sphincter (which is usually weak in reflux disease and cannot stop the acid coming up into the esophagus), and the stomach. Using specialised instruments, the endoscopist will remove the mucosal layer below the sphincter (ARMS), or burn the area around the LES to cause mucosal injury. This will lead to stricture formation/ narrowing that will augment the LES function, thus preventing the acid coming up. Patient selection and anatomical characteristics will dictate if this procedure is feasible, and the doctor will discuss accordingly.
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