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What is Barrett’s esophagus?Barrett’s esophagus is a pre-cancerous condition affecting the lining of the esophagus, the swallowing tube that carries foods and liquids from the mouth to the stomach.
How does Barrett’s esophagus develop?Gastroesophageal reflux disease (GERD) is a disorder in which stomach acid and enzymes cause injury to the esophageal lining, producing symptoms such as heartburn, regurgitation, and chest pain. In some patients with GERD, the normal esophagus cells are damaged. Over time, this damage can result in inflammation and genetic changes that cause the cells to become altered. The tissue takes on a different appearance and microscopically is no longer esophageal tissue, but rather becomes intestinal tissue. This is called “intestinal metaplasia” or Barrett’s esophagus. If a patient has GERD symptoms more than 3 times per week, they should consult their physician.
How is Barrett’s esophagus diagnosed?A diagnosis of Barrett’s esophagus requires that the patient undergo an upper endoscopy procedure by their physician, typically a gastroenterologist or surgical endoscopist. Endoscopy is a non-surgical procedure and is performed using conscious sedation. Barrett’s esophagus tissue appears as a different color on examination, which directs a biopsy of the tissue for pathology evaluation. A finding of intestinal cells in the esophagus (intestinal metaplasia) confirms a Barrett’s esophagus diagnosis.
What are the different types of Barrett’s esophagus?There are different types or “grades” of Barrett’s esophagus, according to biopsy and microscopic findings.
The grades include: • Intestinal metaplasia (IM) without dysplasia • IM with low-grade dysplasia • IM with high-grade dysplasia
“Dysplasia” refers to inherent abnormalities of a tissue or cell that make it more cancer-like and disorganized. While the presence of dysplasia may raise the risk of cancer, it is not considered cancer. Ultimately, higher grades of dysplasia may be considered cancer if there are signs of tissue invasion.
What are the risks of Barrett’s esophagus?Barrett’s esophagus increases the risk for a patient to develop esophageal adenocarcinoma (a specific type of cancer). While all grades of Barrett’s esophagus place the patient at this higher risk, low-grade and high-grade dysplasia are the highest risk sub-types.
HALO Ablation Technology“Ablation” is a technique where tissue is heated until it is no longer viable or alive. Physicians have used various forms of ablation for nearly a century to treat a number of cancerous and precancerous conditions, as well as to control bleeding. The HALO ablation technology is a very specific type of ablation in which heat energy is delivered in a precise and highly controlled manner.
Barrett’s esophagus tissue is very thin and is therefore a good candidate for removal with ablative energy. Delivery of ablative energy with the HALO ablation technology is capable of achieving complete removal of the diseased tissue without damage to the normal underlying structures.
Clinical studies have demonstrated the Barrett’s tissue can be completely eliminated with the HALO ablation technology in 98.4% of patients.
Depending on the extent of the Barrett’s, the Halo360 or Halo90 ablation catheter is introduced into the esophagus and used to deliver energy to the targeted areas.
What to expect after treatment?Patients may experience some chest discomfort and difficulty swallowing for several days after the procedure, both of which are managed with medications provided by the physician. In clinical trials, these symptoms typically resolved within 3-4 days. Patients are provided with anti-acid medications to promote healing of the treated esophagus and replacement of the diseased Barrett’s tissue with a normal, healthy esophagus lining.
A follow-up appointment is scheduled within 2-3 months to assess the response to treatment. If any residual Barrett’s tissue remains, additional therapy may be recommended.
How is GERD managed after a successful ablation?Successful elimination of the Barrett’s esophagus tissue does not cure pre-existing GERD or the associated symptoms. The physician will guide the patient regarding long-term GERD therapy.
For more information or a free physician referral, call TriStar MedLine® at 800-242-5662.
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