ARMS (Anti-reflux Mucosectomy) is a non-surgical procedure that uses rubber bands to create scarring and healing to contract a loose gastro-oesophageal junction (GOJ), which occurs to most people that have acid reflux.

Pre-Op Guidelines for ARMS

Prior to the Anti-reflux Mucosectomy procedure, the patient must ensure that the stomach is empty. This is to allow for a clear view of the gastro-oesophageal junction. This is achieved by staying nil by mouth for at least 6 straight hours before the procedure.

And to know if the ARMS procedure is right for the patient, several tests may be performed, which include:

• Gastroscopy and manometry
• pH (acid) monitoring
• Barium swallow

The patient will also discuss the procedure in detail with his/her attending procedure, whereby they will be told what to expect during and after the procedure as well as the expected results.

The ARMS Procedure

Before the procedure commences, which is performed in an operating theatre under general anaesthesia, the patient will change into a comfortable hospital gown. After the anaesthesia has been administered, a tube will be placed to help you to breath. The RFE, which is a self-adhesive skin pad (electrode) will then be placed on your back, which will be removed after the procedure.

During the ARMS procedure, which takes about 20-30 minutes, the banding device is fitted on the end of a standard endoscope that is normally used when you have endoscopy. The banding device sucks up the stomach wall lining and places a rubber band across the base of this area. The rubber band blocks of the blood supply to this area, then the band drops off and is passed normally through the intestine. This creates a natural ulcer at the area which heals with scarring and tightening over time.

The procedure is done on a day case basis and the patient usually goes home at least two hours after. However, this varies from person to person.

Post-Op Guidelines

After the Anti-reflux Mucosectomy procedure, the patient will be placed in an observation room for two hours whereby the vitals will be checked until he/she is fully recovered after which they will be discharged.

There are important guidelines that the patient has to follow, which include:

• Eating a liquid diet for the next two weeks and only soft foods for the next two weeks afterwards.
• Taking any medication prescribed by the doctor as advised
• Not taking any non-steroidal painkillers.
• Not having any upper GI endoscopy procedures or any tubes into the oesophagus for at least one month

Expected Results After ARMS Procedure

The effect of the procedure start showing over a period of time, whereby symptoms start to improve after about two weeks. Although every case is different, the expectation is that one should either notice fewer symptoms while on the anti-reflux medication or be able to reduce or stop the medication altogether.

Possible Risks and Complications of ARMS Procedure

Just like any other medical procedure, ARMS comes with possible risks and complications which include:

• Chest or abdominal discomfort
• Difficulty belching or swallowing which is rare
• Injury to the lining of the oesophagus
• Bleeding
• Chest infection or fluid build-up which is also very rare

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