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The esophagus is the tube in your chest that moves food to your stomach when you swallow. Barrett’s esophagus develops when the tissue lining in your esophagus thickens due to chronic acid reflux. It is common in people who have frequent acid reflux also known as gastro-esophageal acid reflux (GERD). When Barrett’s esophagus develops, there is a slightly greater chance of developing precancerous cells.
Barrett’s esophagus may present chronic heartburn symptoms; however, many patients will have no symptoms.
Symptoms of GERD include:
Symptoms that may indicate a more serious problem include:
Barrett’s esophagus is diagnosed with endoscopy and biopsy to sample the lining of the esophagus. A sample is taken and sent to pathology for evaluation. If no precancerous change (dysplasia) is detected on biopsy, an acid blocking medication and a repeat endoscopy with biopsy in a few years is typically recommended. If precancerous tissue growth is seen on biopsy, endoscopy therapy may be advised.
At Yale New Haven Hospital, we have a highly skilled team, specially trained in a variety of advanced endoscopy procedures who diagnose and treat disorders, especially potentially cancerous ones such as Barrett’s esophagus. Endoscopic therapy can prevent Barrett’s esophagus with dysplasia (an abnormal change in the cells) from progressing to cancer. This abnormal area can be thick and bumpy or flat in appearance. If treated by a gastroenterologist trained in advanced endoscopy, the specialist will use an endoscope to remove any thickened abnormal tissue from the esophagus using a technique of Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD) to cut out the tissue. A pathologist will then evaluate the tissue and confirm that the abnormal growth was removed. Once the thickened area has been removed, the rest of the flat Barrett’s esophagus is treated by techniques such as radio-frequency ablation (RFA), cryotherapy (freezing the tissue) or hybrid APC (Argon Plasma Coagulation).
Cryotherapy is a treatment that applies extreme cold, created with the use of liquid nitrogen to freeze and destroy abnormal tissue. For Barrett’s esophagus, this is applied using a catheter passed through an endoscope.
Hybrid argon plasma coagulation (APC) for Barrett’s esophagus uses a saline fluid cushion to protect the area when removing the affected tissue.
Radiofrequency ablation for Barrett’s esophagus, or RFA, is the endoscopic application of heat energy to remove the Barrett’s mucosal lining and convert it back to a normal lining.
Barrett’s esophagus treatment may also involve non-surgical life changes to help control acid reflux, these include:
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