Radiofrequency-based treatments for esophageal disease

Background: Gastroesophageal reflux disease and its complication, Barrett's esophagus, are two modern Western epidemics, and they are managed by a combination of medical and surgical approaches. Two new radiofrequency-based endoscopic methods, Stretta and HALO, have been introduced recently, and they are aiming at altering the compliance of the gastroesophageal junction and ablating the Barrett's metaplastic mucosa, respectively. Methods: We reviewed PubMed for all studies pertaining to Stretta and HALO technologies and collected data on techniques, clinical efficacy, safety, tolerability, and durability of effect. Results: Although limitations exist, the safety, efficacy, tolerability, and durability of endoscopic radiofrequency energy application are robust and poised to facilitate the nonsurgical management of gastroesophageal reflux disease (GERD) and Barrett's esophagus. Conclusions: Over the past decade, Stretta and HALO have become valuable options in the current algorithms of management of refractory GERD and Barrett's esophagus. Ongoing vigilance on the long-term benefits of radiofrequency and its effect on esophageal structure and function will allow even wider and more successful applications.