Samuel N. Marcus M.D., Ph.D.

EL CAMINO MEDICAL ASSOCIATES

CROHN'S & COLITIS MEDICAL CLINIC

Treat Barrett’s Esophagus With Radiofrequency Ablation

Often, a seemingly small issue in the gastrointestinal tract can lead to progressively complex problems. Heartburn is a prime example of this. Occasional heartburn is one thing, chronic heartburn (acid reflux) is another – and it can lead to GERD, which can lead to Barrett’s Esophagus; all of these diagnoses put you at higher risk for developing esophageal cancer.

This is why accurate diagnosis and immediate treatment of these GI disorders is so critical.

Barrett’s esophagus is typically diagnosed using an upper endoscopy. It is thought that about 13% of all patients with GERD have Barrett’s Esophagus, evident when healthy esophageal tissue begins to change into intestinal tissue – the result of continuous contact with digestive acid and enzymes.

What is Radiofrequency Ablation (RFA)?

Some of the methods for treating Barrett’s Esophagus are more invasive than others. Our office always tries to use the least invasive method possible to start, only moving to more invasive methods if we have to.  Unlike surgical treatments of Barrett’s, which often require the removal of entire sections of the esophagus, radiofrequency ablation (RFA) uses a form of heat therapy to remove irregular cells, and it has been very useful for treating Barrett’s Esophagus – even cases where large sections of the esophagus were affected.

The RFA procedure uses radiofrequency (energy) waves that are delivered directly to the tissue via a catheter. This way, we have acute control of the waves, minimizing contact with healthy tissue as much as possible. That’s the RF of the RFA. When the RF waves make contact with the diseased tissue cells, it removes a thin layer. This is called ablation.

If you have only small areas of tissue affected by Barrett’s Esophagus, we will use the combination of an endoscope armed with a small catheter. If larger sections require ablation, we’ll use a special balloon-mounted catheter so we can treat larger areas at one time. Once the diseased tissue is removed, the body typically regenerates the affected area with healthy tissue cells, leaving you Barrett’s Esophagus free – or significantly reducing the damage.

To date, RFA has been used effectively to treat more than 60,000 patients suffering from Barrett’s Esophagus and is approved by the FDA.

What Happens During an RFA Procedure?

Because RFA is only minimally invasive, the prep is very straightforward. Depending on your situation, you may need to stop taking or alter the doses of any prescription or over the counter meds you’re currently taking – including meds to control acid reflux. Your doctor will discuss these points with you in detail before procedure day.

You’ll be asked to abstain from eating or drinking anything (including water) after midnight of the evening before the RFA. While you are welcome to drive yourself to our office, we ask that someone else be available to pick you up because you will be under mild sedation and unable to drive.

Once you arrive, you will be positioned on the table and mildly sedated for your comfort. General anesthesia will be administered, so you don’t feel any pain. Typically, a radiofrequency ablation procedure takes between 30 and 50 minutes. When it’s over, the doctor will report how it all went, and you will be sent home with some pain meds. We recommend taking it easy for the rest of the procedure day.

Most patients experience only mild discomfort in their throat and chest for two to four days afterward, but this is managed by prescribed pain medication and anti-inflammatories. You can return to work and your normal daily activities the day after the procedure. To help the area heal as completely as possible, with minimal risk of infection or complications, we recommend adhering to a liquid diet for the first 24 to 48 hours after the procedure and focusing on a soft diet for a week after that.

Would you like to learn more about Barrett’s Esophagus, its diagnosis and treatment via radiofrequency ablation? Contact the office of Dr. Marcus to schedule a consultation.