Patients with Barrett’s Esophagus have a new hero. RF Ablation therapy for Barrett’s Esophagus is a relatively new technological break-through.
At DDC Orlando, we see patients now leading full lives due to extraordinary results from medical techniques that were not readily available 5 or 10 years ago. RF Ablation Therapy is just one of them.
RF Ablation therapy is not really full of mysterious secrets. It’s just not as well publicized as the doctors and staff of Digestive Disease Consultants Orlando believe it should be.
Sometimes medical discoveries and new technologies do not get much mass media exposure. However, in one day they can completely transform a person’s life. RF Ablation is just one such state-of-the-art, 21st-century treatment for Barrett’s Esophagus.
Before we can tell you about the RF ablation procedure, the endoscopic therapy that revolutionizes the management of Barrett’s esophagus, let’s take a brief look at the condition known as Barrett’s esophagus.
Finding a Diagnosis: Barrett’s Esophagus and GERD
Our case study is the patient, Elena. She is preparing for her diagnostic upper endoscopy. Elena has endured intense symptoms of GERD for over a dozen years. Undoubtedly, her gastroenterologist will be looking for evidence of this serious complication of GERD when he examines her esophagus.
To put it simply, Barrett’s esophagus occurs when the normal tissue lining the esophagus changes to tissue that resembles the lining of the intestine. This is caused when “chronic or long-term reflux (regurgitation) of the stomach contents, up into the esophagus, damages the normal inner lining of the esophagus.” With endoscopy, we have images, tissue samples and microscopic studies.
A Microscopic Peek: the Secret Cell Life of Your Barrett’s Esophagus
In Barrett’s Esophagus, we can see that the cells have changed. We consider these cells metaplastic, or metaplasia. Likewise, specialists have placed grades of development in the abnormal cells they find in the esophagus. The finding of these abnormal cells is called dysplasia.
1. Dysplasia: In some Barrett’s esophagus (BE) patients, we see the cells become more abnormal. This is called dysplasia, and it is pre-cancer. However, this type of precancerous cell has no ability to spread to other parts of the body.
2. 2 Grades of Dysplasia: We divide dysplasia into 2 grades based on just exactly how abnormal the cells appear under the microscope: low-grade and high-grade dysplasia. Typically the HGD (high grade) happens over the course of several years.
Barrett’s Esophagus with HGD: Esophagectomy, a Worst Case Scenario
Because of the concern for cancer, the classic treatment for patients with HGD and Barrett’s esophagus was esophagectomy. This surgery was probably the reason Barrett’s esophagus accrued rather ghastly and negative reputation as a dreaded condition. With a morbidity rate of 42 percent and a mortality rate of 3 percent, open esophagectomy was not a popular surgery.
Likewise, the minimally invasive esophagectomy brought complications like pneumonia and anastomotic leak. However, by 2005, a new technology was helping patients with Barett’s Esophagus, and both LGD and HGD: RF Ablation Therapy.
Rescuing You from Barrett’s Esophagus with the BARRX Halo 360, 90 and 60
The subsequent popularity of the new endoscopic technology helped inspire the American College of Gastroenterology to re-write the book on treatment for Barrett’s Esophagus. It contains new guidelines for diagnosing and managing Barrett’s esophagus. It was published in the summer of 2016. Detail-oriented readers can explore the new guidelines in depth in a recent medical article at this reliable online source.
With this endoscopic technology, Barrett’s Esophagus is managed with endoscopic treatment instead of major surgery. Known as the BARRX Halo360, the technology behind the procedure is precise, safe and minimally invasive. Let’s take a brief look at how it works:
The DDC Orlando Patient’s Guide to Endoscopic RF Ablation
The Procedure: In simple terms, radiofrequency ablation (RFA) utilizes radio waves delivered through an endoscope inserted through your mouth into the esophagus. Thus, your DDC Orlando gastroenterologist will destroy abnormal Barrett’s Esophagus cells. At the same time, He will shield the healthy cells underneath.
And here is the wonderful part. The cells that grow in place of the abnormal Barret’s Esophagus, Low-Grade Dysplasia or High-Grade Dysplasia, will be totally normal esophageal cells. (We love seeing this in your follow-up visit.)
Type I: The Balloon Mounted Ablation System
- First, your esophagus must be sized. Your gastroenterologist will insert the correct sized balloon into your esophagus. Don’t worry; you will be sedated and relaxed.
- The doctor inflates the balloon. It is carefully positioned close to Barrett’s tissue. It is cylindrically shaped. Hence, its first name is HALO 360. It makes smooth contact with the walls of the esophagus, all the way around.
- Then he delivers a rapid burst of Radio Frequency. The individualized bursts last for less than a second. This is the energy that heats and eliminates a very thin layer of the diseased cells from the esophagus. The cellular destruction goes less than one millimeter deep.
Type II: The Endoscope-mounted Ablation System
This procedure is accomplished while you are under sedation. You should know that DDC Orlando care team continuously monitors your heartbeat, blood pressure and respiration.
- Smoothly and carefully, your gastroenterologist directs the electrode through the endoscope, and to the diseased area of your esophagus.
- The electrode is shaped differently than the balloon. It looks like a small paddle. However, the function is the same. The doctor delivers short bursts of radiofrequency energy to the diseased area of the esophagus. The treatment will eradicate the abnormal cells. Normal ones will grow in their place within about a month.
Barret’s Esophagus: Seeing the Truth Behind the Fear
Some patients, like our fictional sample case study, Elena, fear medical tests and doctor’s visits. So, they neglect and ignore their symptoms. Some simply misunderstand diseases like Barrett’s esophagus and assume the worst. Others think they are too busy to make the time for testing. If, like Elena, you are anxious about the results from your endoscopic exam, rest assured that only 10% of people who have GERD ever actually develop Barrett’s esophagus. And only 1% of Barrett’s patients ever progress to esophageal cancer.
However, without endoscopy, it is impossible to differentiate between symptoms of GERD, Barrett’s Esophagus and esophageal cancer.
A diagnosis of Barrett’s esophagus brings a higher risk for cancer, specifically esophageal adenocarcinoma. This serious and sometimes fatal cancer strikes no more than 1 % of the patients with Barrett’s esophagus. However, if you have a diagnosis of Barrett’s Esophagus, an essential element of your full and active life should always be to maintain regularly scheduled check-ups with your doctor.
A Special Note for Potential Patients with Barret’s Esophagus
Only your gastroenterologist will be able to discover and treat cancerous and precancerous cells early. As is the case with most cancer, early detection is crucial. According to Covenant Health research, patients with Barrett’s esophagus have 30-125 times greater risk of esophageal cancer. With minimally invasive procedures such as endoscopic therapies available at Digestive Disease Consultants Orlando, you can release yourself from the anxiety of being in that high-risk group.
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