Barrett’s Esophagus

Receiving a diagnosis of Barrett’s esophagus can feel shocking. And the potential complications of this condition can be even scarier.

A gastroenterologist can help you manage your condition and reduce your risk of esophageal cancer.

This page will first discuss what Barrett’s esophagus is. We’ll then highlight what you should know about Barrett’s esophagus without dysplasia and Barrett’s esophagus with dysplasia. Lastly, we’ll discuss Barrett’s esophagus treatment, which includes radiofrequency ablation.

Barrett’s esophagus is a complication that develops from chronic gastroesophageal reflux disease (GERD). If you have GERD, stomach acid flows back into the esophagus. This causes chronic inflammation of the esophagus, which can lead to cellular damage.

Damage to cells in the esophagus can result in intestinal metaplasia. This is when cells in the small intestine replace the cells that usually line inside the esophagus.

The inside of the esophagus is naturally light pink and smooth. But Barrett’s esophagus causes the esophageal lining to become thick and red. The cells in Barrett’s esophagus may grow abnormally and become precancerous over time. This is known as dysplasia.

A diagnosis of Barrett’s esophagus with dysplasia increases your risk of esophageal cancer. But this doesn’t mean you will get cancer. Over 90% of people with Barrett’s esophagus do not develop cancer.

Non-dysplastic Barrett’s epithelium is the earliest stage of Barrett’s esophagus. This occurs when intestinal cells replace esophageal cells. But there are no signs of precancerous changes. If you receive a diagnosis of Barrett’s esophagus without dysplasia, you will need endoscopy screening every 3-5 years. This can detect cellular changes in the esophagus.

Barrett’s esophagus with dysplasia occurs when there are precancerous changes in the cells of the esophagus. In some cases, dysplasia can progress to esophageal cancer. You may need more frequent monitoring if you receive a diagnosis of Barrett’s esophagus with dysplasia.

Low-Grade Dysplasia

Low-grade dysplasia occurs when Barrett’s esophagus cells develop minor abnormalities. This is an early form of pre-cancer. If you have low-grade dysplasia, you most likely will not get esophageal cancer. But there is a low risk. Treatment for low-grade dysplasia involves radiofrequency ablation.

High-Grade Dysplasia

High-grade dysplasia occurs when Barrett’s esophagus cells develop extensive abnormalities. This is an advanced form of pre-cancer. If you have high-grade dysplasia, your chances of getting esophageal cancer increase. Treatment for high-grade dysplasia may include esophageal mucosal resection and radiofrequency ablation. This can reduce your risk of esophageal cancer.

Esophageal Adenocarcinoma

Esophageal adenocarcinoma is an aggressive form of esophageal cancer. This is the last stage of Barrett’s esophagus. If adenocarcinoma is not detected early, it may spread to other parts of the body. The treatment for esophageal adenocarcinoma involves an esophagectomy. This is a surgical procedure that removes portions of the esophagus.

Barrett’s esophagus treatment focuses on reversing the cellular changes in the esophagus. Depending on the severity of Barrett’s esophagus, treatment will vary. Barrett’s esophagus treatment may include:

• Radiofrequency ablation
• Endoscopic mucosal resection
• Esophagectomy

We’ll discuss one of the treatments we offer — radiofrequency ablation — in more depth below.

Radiofrequency Ablation (RFA)

Radiofrequency ablation uses radio waves to remove precancerous cells from Barrett’s esophagus. This is an outpatient procedure that can treat Barrett’s esophagus with dysplasia.

If you have high-grade dysplasia, you may need radiofrequency ablation and endoscopic mucosal resection.

Preparation for radiofrequency ablation begins by fasting at midnight on the day of your procedure. This means no water, gum, smoking tobacco, or smokeless tobacco. If you don’t follow these guidelines, you will need to reschedule your procedure.

We will administer anesthesia during the procedure. This puts you to sleep and prevents you from feeling anything. For this reason, you will need to arrange for someone to drive you home.

After your procedure, you cannot use non-steroidal anti-inflammatory drugs (NSAIDs) for 7 days. This means no:

• Aspirin
• Ibuprofen
• Naproxen sodium

You’ll receive prescribed medications to help you recover from Barrett’s esophagus. Make sure to take these medications as recommended. Your prescribed medications may include:

• Oral pain medication to reduce pain as needed
• Sucralfate oral suspension to protect the esophagus from acid reflux
• Proton pump inhibitor (PPI) to reduce stomach acid

You’ll need to follow a special diet for the first week after your procedure. You can then return to a regular diet as tolerated. Your post-procedure diet includes:

• Eating cold or room temperature liquids for 24 hours
  • No carbonated beverages
• Eating a soft diet for 1 week

You may experience pain and difficulty swallowing while recovering from your procedure. This is perfectly normal and will improve with time. But you should contact our office if you experience worsening symptoms.

Risks of Radiofrequency Ablation

Radiofrequency ablation is usually a safe procedure. But every procedure has risks. Risks of radiofrequency ablation include:

• Perforation of the esophagus
• Bleeding
• Aspiration
• Esophageal strictures
• Chest pain
• Recurrence of Barrett’s esophagus

You should contact our office if you experience any symptoms, including:

• Abdominal pain
• Bleeding
• Chest pain
• Difficulty breathing
• Fever
• Severe difficulty swallowing
• Vomiting

If you cannot reach our office, you should go to the nearest emergency room.

Barrett’s esophagus is a life-long condition that can progress over time. You will need regular screening and treatment to decrease your risk of esophageal cancer. Making lifestyle changes to reduce symptoms of GERD can also prevent your condition from worsening.

You can reduce symptoms of GERD by:

• Quitting smoking
• Maintaining a healthy weight
• Eating smaller meals
• Avoiding trigger foods for acid reflux
  • Acidic foods
  • Spicy foods
  • Fatty foods
  • Alcohol
  • Peppermint
  • Chocolate
• Elevating your head for 2-3 hours after eating

Dr. Sameer Islam is a gastroenterologist and West Texas native. He helps manage your digestive conditions and prevent the development of medical complications.

If you want to discuss if Barrett’s esophagus treatment is right for you, please call our office at (806) 696-4440 or schedule an appointment online.