What is ARMA Treatment?

ARMA is an endoscopic treatment method developed to prevent stomach acid and contents from escaping back into the esophagus (reflux), which does not require a surgical incision (minimally invasive).

At the junction of the stomach and the esophagus, there is a valve mechanism called the lower esophageal sphincter (LES) that prevents acid from escaping upwards. In reflux patients, this area is usually loose. The main purpose of the ARMA treatment is to narrow and tighten this loose valve by triggering the body’s own healing mechanism, without using any foreign objects, implants, or stitches.

When is it Applied? (Who is it Suitable For?)

ARMA is not for every reflux patient, but is an ideal option for patients who meet certain medical criteria. It is generally preferred in the following situations:

• Medication-Resistant or Dependent Reflux: Patients whose symptoms do not fully resolve despite using stomach protectors (PPIs) or who do not want to take pills for life.

• Mild to Moderate Valve Looseness: Those with mild or moderate anatomical deterioration in the valve (LES) structure at the lower end of the esophagus.

• Those Who Do Not Want Surgery: Patients who are hesitant about traditional reflux surgery (such as laparoscopic fundoplication) and do not want to take the risks that surgery and a long recovery process may bring.

• Those Without a Large Hiatal Hernia: Patients with advanced hiatal hernias generally require more comprehensive surgical methods; ARMA may not be a suitable option for these patients.

How is the ARMA Procedure Performed? (Treatment Method)

ARMA is a very comfortable and practical procedure for the patient that does not require hospitalization. The process proceeds step by step as follows:

1. Preparation and Anesthesia: As in a standard endoscopy procedure, the patient is asked to fast for a certain period before the intervention. The procedure is performed under sedation, where the patient is completely asleep. This ensures the patient does not feel any pain, ache, or discomfort during the procedure.

2. Endoscopic Intervention (Ablation): A flexible tube with a camera at its tip (endoscope) is inserted through the mouth down to the lower end of the esophagus. Controlled heat energy is applied to the area where the valve is located using a special device called “Argon Plasma Coagulation (APC)”. This process creates a superficial and controlled ablation (tissue damage/burn).

• Safety Detail: In order to prevent swallowing difficulties (dysphagia) in the future, the procedure is not performed on the entire circumference (360 degrees), but generally on a portion of about 270 degrees. The remaining small area is intentionally left intact.

3. Duration: The procedure is completed in a short time, averaging 20 to 30 minutes.

4. Healing and Tightening Mechanism: This superficially created wound shrinks (forms scar tissue) as it heals over weeks. This shrinking and scarring effect allows the loose valve to naturally contract, narrow, and tighten. Thus, the upward escape route of stomach acid is effectively closed.

Post-Procedure and Recovery Process

• Rapid Discharge: Patients rest in the recovery room for a while after the procedure and can usually be discharged on the same day within 1-2 hours to return to their daily lives.

• Dietary Regimen: Liquid and soft foods are generally consumed on the day of the procedure and the following few days. A normal diet can be resumed in a short time, provided that excessively spicy or sour foods are avoided.

• Waiting Period for Permanent Effect: The main effect of the procedure does not appear immediately that day, but gradually emerges as the tissue heals and shrinks. This process takes an average of 1 to 2 months. During this period, the use of stomach protectant medications recommended by the physician may continue; the goal is to stop the medications once healing is complete.

ARMA is one of today’s most innovative treatment options for patients who want to permanently get rid of reflux complaints, boasting high success rates and a low risk of complications.