Barrett's Esophagus

Tests & Treatments

How is Barrett’s esophagus diagnosed?

There are a number of ways to treat Barrett’s esophagus, but first your doctor will want provide you with a firm diagnosis. If you are showing persistent symptoms of GERD your doctor may want to preform an endoscopy.

Barrett’s esophagus is diagnosed by endoscopy, a safe outpatient procedure where a flexible tube with a camera is passed through the mouth to look at the lining of the esophagus and take a small tissue sample (biopsy). Often, the endoscopist can notice a change in the appearance of the lining of the esophagus that suggests the presence of Barrett’s esophagus. However, the diagnosis can only be confirmed by carefully examining the biopsy under a microscope.

Barrett’s esophagus is believed to increase the risk of developing esophageal cancer. Most physicians recommend that people with Barrett’s esophagus undergo endoscopy about every two years to screen for cancer and allow early treatment. In some cases more frequent endoscopy is recommended.

Medications:

Here are some medications to reduce stomach acid and control the symptoms of GERD include antacids, proton pump inhibitors and H2 receptor antagonists:

  • Antacidswork by neutralizing acid that is present in the stomach. Antacids are of value for patients who have intermittent symptoms that require quick relief. However to treat an ulcer frequent dosing is necessary and more effective medications are now present.
  • Proton Pump Inhibitors (PPIs)are the most effective medications for lowering acid and treating ulcer disease. They work by blocking proton pumps that secrete acid in the stomach and block acid the strongest.
  • H2 receptor antagonistswork by blocking histamines that stimulate acid secretion in the stomach. These are prescriptions drugs but some are now available as over the counter medications that do not requires a doctor’s prescription.

How do you treat Barrett’s esophagus?

Treatment options vary by the stage or severity of Barrett’s esophagus and the doctor will recommend the best option.

Surveillance

One way a doctor may recommend Barrett’s esophagus be treated following a diagnosis is surveillance with endoscopy and biopsy. This essentially means your doctor will perform an examination of your esophagus and sample the affected tissue. This will be done at various intervals to monitor disease progression to more advanced stages. The frequency of these tests may vary depending on the stage or severity of the Barrett’s esophagus.

Endoscopic Options

A number of endoscopic therapy options are available to treat Barrett’s esophagus. Endoscopic therapy options offer a variety of means to remove the diseased lining of the esophagus via resection of the tissue.

Radiofrequency Ablation

Radiofrequency ablation (RFA) uses heat to treat Barret’s esophagus by removing affected tissue while preserving the underlying healthy tissue. RFA is a proven technology that reduces the relative risk of disease progression to esophageal cancer.

Watch the below animation developed by Medtronic to see how the BarrxTM radiofrequency ablation system works and learn about what you can expect from the procedure.


Reference 1: Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277-88,
Reference 2: Phoa KN, van Vilsteren FG, Pouw RE, Weusten BL, et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA. 2014 Mar 26;311(12):1209-17
Reference 3: Wolf WA, Pasricha S, Cotton C, et al. Incidence of Esophageal Adenocarcinoma and Causes of Mortality after Radiofrequency Ablation of Barrett’s esophagus. Gastroenterology. 2015;149:1752-1761.)

These resources were made possible through a partnership between Medtronic and CDHF

Tests & Treatments

How is Barrett's esophagus diagnosed?

There are a number of ways to treat Barrett's esophagus, but first your doctor will want provide you with a firm diagnosis. If you are showing persistent symptoms of GERD your doctor may want to preform an endoscopy.

Barrett’s esophagus is diagnosed by endoscopy, a safe outpatient procedure where a flexible tube with a camera is passed through the mouth to look at the lining of the esophagus and take a small tissue sample (biopsy). Often, the endoscopist can notice a change in the appearance of the lining of the esophagus that suggests the presence of Barrett’s esophagus. However, the diagnosis can only be confirmed by carefully examining the biopsy under a microscope.

Barrett’s esophagus is believed to increase the risk of developing esophageal cancer. Most physicians recommend that people with Barrett’s esophagus undergo endoscopy about every two years to screen for cancer and allow early treatment. In some cases more frequent endoscopy is recommended.

Medications:

Here are some medications to reduce stomach acid and control the symptoms of GERD include antacids, proton pump inhibitors and H2 receptor antagonists:
  • Antacidswork by neutralizing acid that is present in the stomach. Antacids are of value for patients who have intermittent symptoms that require quick relief. However to treat an ulcer frequent dosing is necessary and more effective medications are now present.
  • Proton Pump Inhibitors (PPIs)are the most effective medications for lowering acid and treating ulcer disease. They work by blocking proton pumps that secrete acid in the stomach and block acid the strongest.
  • H2 receptor antagonistswork by blocking histamines that stimulate acid secretion in the stomach. These are prescriptions drugs but some are now available as over the counter medications that do not requires a doctor’s prescription.

How do you treat Barrett's esophagus?

Treatment options vary by the stage or severity of Barrett’s esophagus and the doctor will recommend the best option.

Surveillance

One way a doctor may recommend Barrett's esophagus be treated following a diagnosis is surveillance with endoscopy and biopsy. This essentially means your doctor will perform an examination of your esophagus and sample the affected tissue. This will be done at various intervals to monitor disease progression to more advanced stages. The frequency of these tests may vary depending on the stage or severity of the Barrett’s esophagus.

Endoscopic Options

A number of endoscopic therapy options are available to treat Barrett's esophagus. Endoscopic therapy options offer a variety of means to remove the diseased lining of the esophagus via resection of the tissue.

Radiofrequency Ablation

Radiofrequency ablation (RFA) uses heat to treat Barret's esophagus by removing affected tissue while preserving the underlying healthy tissue. RFA is a proven technology that reduces the relative risk of disease progression to esophageal cancer. Watch the below animation developed by Medtronic to see how the BarrxTM radiofrequency ablation system works and learn about what you can expect from the procedure. [embed]https://www.youtube.com/watch?v=s9khaVztuRo[/embed]
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Reference 1: Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277-88,
Reference 2: Phoa KN, van Vilsteren FG, Pouw RE, Weusten BL, et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA. 2014 Mar 26;311(12):1209-17
Reference 3: Wolf WA, Pasricha S, Cotton C, et al. Incidence of Esophageal Adenocarcinoma and Causes of Mortality after Radiofrequency Ablation of Barrett’s esophagus. Gastroenterology. 2015;149:1752-1761.)
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