Barrett’s esophagus treatment depends mainly on two things: degree of dysplasia present in a patient’s esophagus cells and patient’s overall health. Before we look into various treatments for Barrett’s disease, let’s take a brief look on what it is, how it is related to GERD, and how it is diagnosed.
Barrett’s Esophagus – what is it and how it is related to GERD?
Barrett’s is a serious complication of gastroesophageal reflux disease or GERD for short. In GERD, the gastric acid produced to aid digestion occasionally flows upwards into the food pipe, also known as the esophagus tube. This upward movement irritates the esophagus lining and causes GERD.
When GERD complicates, tissue lining the esophagus tube change to resemble the tissue found in the inner lining of the intestine. This abnormal change is medically known as Barrett’s Esophagus.
Not every GERD patient develops Barrett’s Esophagus. In fact, only 10% of GERD patients are later diagnosed with Barrett’s Esophagus.
Barrett’s Esophagus in itself is not a fatal condition. However, it does increase the risk to a potentially life-threatening cancer of the esophagus. With that said, esophageal cancer is a rare condition and only 1% of Barrett’s patients develop it. Regular tests can help early identification of this cancer and prevent the cancerous cells from spreading to other regions.
The symptoms of Barrett’s Esophagus are similar to GERD and include frequent heartburn, problem swallowing food, and pain in the chest.
How Barrett’s Esophagus is diagnosed
With the condition having no unique symptoms, diagnosing it without any tests becomes impossible. Upper endoscopy and biopsy are used for diagnosing it.
Barrett’s Esophagus treatment is different for no or low-grade dysplasia and high-grade dysplasia patients.
No or Low-grade Dysplasia
The treatment focuses on medicines (over-the-counter and/or prescription-based), a healthy diet and lifestyle, and regular check up.
Medicine and lifestyle changes
To ease the signs and symptoms of GERD, your doctor may give you certain medications, like antacids to neutralize gastric acid, H-2-receptors blockers to reduce the production of the stomach acid, Proton pump inhibhitors to severly block acid production and heal the lining of the esophagus.
In addition to medicines, your doctor will recommend you to follow a healthy diet, stop smoking if you are a smoker, reduce alcohol intake if you take more than the recommended quantity, take smaller meals, and eat the last meal a couple of hours before bed time.
Endoscopy at regular intervals
To detect any further damage, periodic endoscopy is recommended to Barrett’s Esophagus patients. A follow-up endoscopy within 12 months is generally recommended to patients whose first endoscopy did not reveal any dysplasia. If the follow-up endoscopy, too, showed no deterioration, the next follow-up endoscopy is usually scheduled three years later. In case the first follow-up endoscopy showed low-grade dysplasia, you may be asked to get another endoscopy done within the next 6 months.
Barrett’s Esophagus treatment when high-grade dysplasia is involved revolves around the following:
- Endoscopic resection. The procedure involves use of an endoscope to extricate cells that are damaged.
- Radiofrequency ablation. In this abnormal tissue in the esophagus is removed using heat.
- Cryotherapy: The abnormal cells are first thawed and then frozen using an endoscope for applying cold gas or a liquid. Thawing followed by freezing, in turn, kills the abnormal cells.
- Surgery: The part of the esophagus that is damaged is surgically removed and the stomach in connected with the remaining part.
- Photodynamic therapy. Abnormal cells are destroyed by making them sensitive to light