Radiofrequency ablation (RFA) is one of the valuable treatment options for Barrett's esophagus, a digestive condition that raises a person's risk of developing esophageal cancer. Consult with our gastroenterologists in Phoenix, AZ to determine the best course of treatment for your condition.

What Is Barrett's Esophagus?

Barrett's esophagus is a gastroesophageal reflux disease (GERD) complication wherein cells like those found in the small intestine replace the esophagus' normal tissue lining. People with this condition are at an increased risk of developing a rare esophageal cancer.

What Causes Barrett's Esophagus?

Barrett's esophagus is more common in people with GERD, as experts believe that the acidic liquid damages the esophageal lining, which leads to tissue changes. However, GERD severity or frequency does not affect a person's chances of developing Barrett's. Some patients without GERD can also have Barrett's esophagus. 

Is Barrett's Esophagus Serious?

Barrett's esophagus does not cause symptoms, but acid regurgitation and heartburn are its associated conditions. Watch out for these symptoms, as they may be a sign of worsening GERD or possible Barrett's esophagus:

• Difficulty swallowing.
  
• A feeling of food stuck in the esophagus.
  
• Vomiting.
  
• Heartburn which happens at least twice per week.
  
• Worsening heartburn.
  
• Heartburn that wakes you from sleep.
  
• Blood in stool.
  
• Constant sore throat.
  
• Sour taste in the mouth.

Can Barrett's Esophagus Be Reversed?

Barrett's esophagus does not go away or return to normal even if treated with acid reflux medications. But this condition can progress into a precancerous state and further progress into cancer. As such, Barrett's esophagus treatments aim to prevent esophageal cancer by getting rid of precancerous growths.

Barrett's esophagus is classified based on the presence of precancerous cells:

• No dysplasia – Barrett's esophagus shows no signs of precancerous changes.
• Low-grade dysplasia – indicates the presence of some abnormal cells. You may need more frequent checkups to see how your condition is progressing. You can expect an upper endoscopy every six to 24 months. Ablation therapy may be recommended only if your condition shows progression to early cancer.
• High-grade dysplasia – the cells show substantial precancerous changes. Frequent upper endoscopies may be recommended to look for cancer sites. Radiofrequency ablation (RFA) is one of the treatment procedures that may be recommended to remove damaged tissue.

What Is Radiofrequency Ablation (RFA) Treatment?

Radiofrequency ablation treatment is a method that uses high-energy radio waves to heat and destroy precancerous cells. It is also a pain management technique wherein the radio waves are directed to a nerve area. RFA is one of the possible treatments for Barrett's esophagus.

It is rare for patients with Barrett's esophagus to receive RFA, as this condition rarely progresses to precancerous changes. The American College of Gastroenterology only recommends RFA therapy to all patients with high-grade dysplasia. 

Patients with low-grade dysplasia without a short life expectancy may be recommended for RFA, but another alternative is to perform this procedure only if there are signs of the Barrett's progressing to early cancer or high-grade dysplasia. Low-grade dysplasia patients only need endoscopies every 12 months to monitor the progress of their Barrett's esophagus.

On average, one to three RFA sessions are required to completely remove dysplastic tissues or the Barrett's esophagus. Follow-up endoscopies will also be done every two to three months to assess a patient for further treatment.

How Does RFA Work?

Being referred for RFA to treat Barrett's esophagus can be intimidating. At Abrazo Digestive Specialists in Phoenix, AZ, we will do our best to walk you through the procedure and preparations you must make. Please take this opportunity to ask your questions and clarify anything. Depending on your health condition, you will receive either general anesthesia or deep sedation before the procedure.

During the RFA procedure, a gastroenterologist will use a balloon catheter or an endoscope (thin, flexible tube with a camera) mounted with an electrode. The electrode releases energy which results in a high temperature that burns the Barrett's lining. The process can take up to 35 minutes and lead to tissue ablation. The burned tissue sheds 48 to 72 hours after RFA and is expected to be replaced by normal lining over six to eight weeks.

After the procedure, your doctor will give you instructions for your recovery. They will schedule you for a follow-up appointment. Your doctor may recommend a modified diet during the first few days after your RFA. You will be prescribed the following medications to help with your recovery and symptoms:

• Pain relievers
• Numbing medications
• Acid suppressants
• Ulcer coating medicine

A low-acid environment will allow the esophagus to grow normal tissues to replace the RFA-destroyed ones. All RFA patients will be indefinitely treated with high-dose acid-suppressing medications (proton pump inhibitors). After normal tissue has replaced the destroyed Barrett's, you will need to undergo upper endoscopy occasionally to ensure your condition does not reoccur.

Recommendations

RFA is just one of the many therapies available to remove or destroy Barrett's esophagus. Our gastroenterologists will explain your options to you and thoroughly assess your health condition to recommend the most appropriate treatment for you.

No digestive problem is too small or too big for Abrazo Digestive Specialists. If you are worried about recurring symptoms affecting your digestive system, now is an excellent time to speak with one of our digestive health specialists in Arizona for proper diagnosis, evaluation and treatment. Please don't delay care. We are always here to help take care of your digestive health.

Sources:
American College of Gastroenterology
Cleveland Clinic
Digestive Healthcare Center
Johns Hopkins Medicine
National Institute of Diabetes and Digestive and Kidney Diseases
National Library of Medicine