Radiofrequency Correction of GERD Procedure (Stretta) Corrects Gastroparesis Associated with Medically Refractory GERD Mark D. Noar, Sahar Lotfi Gastroparesis can occur concommitantly in up to 25% of patients with GERD. After GERD correction via procedures like Nissen and Radiofrequency (RF) correction, gastroparesis is known to improve. The incidence and change in gastroparesis was studied in a large population of patients undergoing RF correction of GERD. Aim: To determine if RF treatment for GERD will result in the improvement of gastroparesis in patients with both GERD and an abnormal Gastric Emptying Scan (GES). Methods: From July 2000-2005, 227 patients undergoing RF correction for GERD were screened. Patients with gastroparesis, on standardized nuclear gastric emptying scan, and heartburn and regurgitation uncontrolled by PPI BID medications underwent RF ablation of the cardia and esophagogastric junction. Pre-treatment, patients had EGD, manometry, and solid-phase gastric emptying, electrogastrography, and completed standardized heartburn, dyspepsia and satisfaction surveys. Patients with pyloric obstruction or taking motility agents were excluded. Gastric emptying scans were repeated 6-8 months post-Stretta, and surveys 6, 12, 24, 36 and 48 months later. Nuclear radiologist was blinded to study design. Paired t test using SAS used for analysis. Results: 31 patients (14%) were classified as abnormal at baseline assessment. At 6-8 months, emptying scores improved significantly with the percentage of solid food emptied at 90 minutes improving from 41% prior to Stretta to 66% (p ! 0.0001). GES at 120 minutes improved from 55% to 84%. Significant improvements were seen at all GES time intervals. Overall, 23 patients experienced normalization of gastric emptying, 8 were improved but remained abnormal. 4 patients showed no improvement in their GES with 1 patient electing to undergo a Nissen procedure. Corresponding improvements were seen in heartburn, dyspepsia and patient satisfaction with a mean improvement from 1.3 to 4.5 in patient satisfaction. All improvements were significant (p ! 0.001). Conclusions: 1) RF treatment or Stretta has been demonstrated to correct gastroparesis, 2) Patients’ symptoms improved significantly, 3) RF correction of reflux, similar to Nissen fundoplication, can result in the reversal of gastroparesis, 4) The mechanism of action is unknown, but is likely due to a combination of a reduction in TLESRs, increase in the EGJ barrier, decreased esophageal venting, and/or alteration of the gastric pacemaker function in the region of RF therapy administration.