Anti Reflux Mucosal Ablation (ARMA) is a procedure used in the treatment of gastroesophageal reflux disease (GERD). The procedure is performed endoscopically by sleeping.

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    What is ARMA- Anti Reflux Mucosal Ablation?


    is an effective reflux treatment with endoscopy.
    The procedure is performed by putting him to sleep under sedation like other endoscopic procedures. It takes about 20-30 minutes. It is very easy and safe to apply. With an argon plasma coagulator, coagulation is applied to the horseshoe-shaped mucosa 1 cm below the cardioesophageal junction and 1 cm away from the endoscopy device. The width of the horseshoe-shaped lesion is 1 cm, while the middle section is recommended to be 2 cm wide.

    There are still 3-year follow-ups in the literature. Accordingly, the success rate is reported as 75-80%. In other words, 7 or 8 of the ten patients who underwent the procedure benefit. The reason why the success is not 100% is that the process is done 270 degrees, not 360.

    The reason why coagulation is not performed in a completely circular manner is to prevent the development of stricture, that is, stenosis, later. Otherwise, since swallowing difficulty may occur in patients, the intervention is performed at 270 degrees. The side where coagulation is applied should be the small curvature side. The open end of the horseshoe, that is, the area that is left open by 1 centimeter and not touched, should be on the side of the large curvature. The coagulation lesion is covered with normal mucosa within 2 months. Due to shrinkage during healing, the lower esophageal sphincter tightens.


    How is Endoscopic Reflux Treatment ARMA Performed?

    “ARMA” or “Anti-Reflux-Mucosal-Ablation” (ARMA), a method used for endoscopic reflux treatment, is an endoscopic procedure used to treat reflux disease. This process aims to prevent stomach acid from escaping back into the esophagus. ARMA aims to improve the functioning of the muscle called the lower esophageal sphincter (LES), which causes stomach contents to escape back into the esophagus.

    The steps followed in the treatment of endoscopic reflux are as follows;

    1. Preparation: Since it is an endoscopic procedure, the patient should come hungry. You will be given all the necessary instructions before the procedure.
    2. Anesthesia Examination: The ARMA procedure is performed by putting you to sleep under sedation. This ensures that the patient does not feel anything during the procedure. For this reason, before the patient is processed, information is obtained by contacting our anesthesiologist.
    3. Endoscopy: The procedure starts like a normal endoscopy procedure. During the procedure, the condition of the valve is determined first. If the patient’s condition is suitable for the Arma application, the ARMA process is started.
    4. ARMA Application: The ARMA procedure is applied in the lower part of the esophagus to prevent stomach contents from escaping back into the esophagus. During this process, a controlled combustion process with argon plasma is applied. A 270-degree controlled injury is made. It allows to improve the function of the lower esophageal sphincter by compressing and narrowing the application area.
    5. After the procedure: After the procedure, the patient rests in the rest section until the effect of the narcosis wears off. Discharge is performed approximately 1 hour after the procedure. A slight feeling of pressure or discomfort that lasts for a few days after the procedure is normal.
    6. Recovery Period: The patient continues to use the medications given for the first month after the procedure. In the following month, a decrease in reflux complaints is expected after discontinuing the drugs. The time to fully show the effect of the procedure is usually 2 months.

    Keep in mind that ARMA is an option for reflux treatment and may not be suitable for every patient. You can contact us to find out if you are eligible for the ARMA process or to learn more about the process.


    Who Needs Surgical or Endoscopic Reflux Surgery?

    • If proton pump inhibitors do not provide sufficient control in reflux patients with complaints
    • Even if they are under control with medication, those who do not want to use medication for a long time and want to be treated at once
    • Those with Barrett’s esophagus
    • Those with extra esophageal findings
    • Young patients
    • Those who have problems with compliance with the drug, those who disrupt their medication
    • Postmenopausal ladies with osteoporosis
    • Those who have conduction defects in the heart and may have rhythm problems
    • Those who keep the cost of drug treatment high, those who do not have social security, who will have to buy their medicine with money all the time
    People need
    reflux surgery or Endoscopic Reflux Treatment – ARMA


    Endoscopic reflux treatment with argon plasma coagulation procedure- ARMA


    Sample Patients:  Before and After the Procedure

    Example 1

    Example 2

    Example 3

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