Anti-Reflux Mucosal Ablation (ARMA) is an endoscopic technique used in selected patients with gastroesophageal reflux disease. The aim is to strengthen the anti-reflux barrier at the gastroesophageal junction by producing controlled mucosal injury followed by tissue healing and contraction.

During ARMA, the endoscopist applies controlled thermal ablation to selected mucosal areas around the gastroesophageal junction. As the treated tissue heals, scar formation and contraction may help narrow the junction and reduce reflux of stomach contents into the esophagus.

Before the procedure, evaluation may include upper GI endoscopy, reflux testing and esophageal manometry. The presence and size of a hiatus hernia, esophageal motility and previous response to acid-suppressing medication are among the factors considered when deciding whether ARMA may be appropriate.

ARMA is not suitable for every patient with reflux. Possible adverse effects can include discomfort, bleeding, ulceration or narrowing of the treated area. Clinical follow-up is required to assess symptom response and healing.