What is ARMA?
Anti-Reflux Mucosal Ablation (ARMA) is a cutting-edge endoscopic procedure designed to treat Gastro-Oesophageal Reflux Disease (GORD) in patients who continue to experience symptoms despite acid-lowering medications.
Originally developed in Japan in 2014, ARMA offers a safe, non-surgical alternative to traditional fundoplication, helping to restore the natural barrier at the gastro-oesophageal junction and reduce reflux.
Who Might Benefit from ARMA?
ARMA may be appropriate for patients who:
-
Have ongoing reflux symptoms despite medication
-
Have no large hiatus hernia
-
Prefer a less invasive option than surgery
How Does ARMA Work?
During a gastroscopy, a shallow ring-shaped burn is created at the top of the stomach using argon plasma coagulation. As this area heals, scar tissue forms, narrowing the junction and re-establishing a natural anti-reflux barrier (Hill Grade 1 flap valve).
The result? Fewer reflux episodes, reduced symptoms, and in many cases, less reliance on daily medication.
Pre-Procedure Investigations
Before undergoing ARMA, you may need:
-
Gastroscopy – to assess anatomy and check for hiatus hernia
-
24-hour pH study – to measure acid exposure in your oesophagus
-
Oesophageal manometry – to assess muscle function in the oesophagus
These tests ensure ARMA is the right fit for your individual condition.
What to Expect
-
Procedure duration: 30–40 minutes
-
Hospital stay: Usually same-day discharge
-
Recovery: Gradual return to normal diet over one week
-
Medication: 8 weeks of high-dose proton pump inhibitors (PPIs) post-procedure
-
Follow-up: Symptom review at 3 and 6 months, with repeat pH testing and gastroscopy
Recovery Diet Plan
Days | Diet Type | Description |
---|---|---|
Day 1 | Liquid Only | Water, juice, protein-rich drinks (e.g. Ensure, Up & Go) |
Days 2–3 | Puree Diet | Blended vegetables, fruit, porridge, mashed tofu |
Days 4–6 | Soft Diet | Mashed vegetables, soft meats, stewed fruit, scrambled eggs |
Small, frequent meals and sitting upright while eating are recommended.
Potential Risks
ARMA is generally very safe, but like all procedures, it carries some risks:
-
Bleeding (3%) – usually minor and managed during the procedure
-
Temporary pain – common in the first few days
-
Difficulty swallowing (13%) – may require gentle balloon dilation
-
Persistent reflux symptoms (up to 20%)
-
Rare complications: infection, fever, or perforation (very uncommon)