Barrett's Esophagus Expertise
The Center for Advanced Endoscopy at Beth Israel Deaconess Medical Center offers comprehensive care for individuals with Barrett's esophagus, including diagnostic testing, advanced treatment options, and ongoing monitoring and follow-up care. Barrett's esophagus is a pre-cancerous condition in which the lining of the esophagus-the tube that carries food from the throat to the stomach-is damaged by stomach acid. Left undiagnosed and untreated, Barrett's esophagus can lead to esophageal cancer. With early diagnosis, appropriate treatment and continuous follow up, Barrett's esophagus can be managed successfully.
In most cases, Barrett's esophagus is preceded by acid reflux, also known as gastroesophageal reflux disease (GERD). When we eat, a valve between the esophagus and the stomach opens to let food in, then closes to prevent stomach acid and enzymes from entering the esophagus. In individuals who have GERD, the valve is defective and does not close completely or does not close at all. Stomach acid that backs up into the esophagus causes GERD symptoms. Examples of GERD symptoms include:
- Chest pain or discomfort
- A burning sensation in the throat
- Sore throat
- Chronic cough
- Nausea after eating
- Sleep disorders
- Trouble swallowing
GERD is a common condition. In fact, almost 44 percent of Americans experience GERD symptoms on a monthly basis and almost 18 percent experience them weekly. Individuals who have symptoms more than twice weekly should be evaluated by a physician. Left undiagnosed and untreated, GERD may lead to a more serious condition called Barrett's esophagus, which, in turn, can lead to esophageal cancer. An estimated 13 percent of individuals who have chronic GERD also have Barrett's esophagus.
About Barrett's Esophagus
Barrett's esophagus, is a pre-cancerous condition that involves damage to the lining of the esophagus. In people with Barrett's esophagus, the damage and inflammation caused by GERD causes genetic changes that cause normal esophagus tissue to change into intestinal tissue, which places them at a higher risk for esophageal cancer.
An estimated 3.3 million adults over age 50 have been diagnosed with Barrett's esophagus in this country. Individuals with Barrett's esophagus are 30 to 125 times more likely to develop esophageal cancer. Men develop Barrett's esophagus twice as often as women, and Caucasian men are affected more often than men of other races. Barrett's esophagus does not cause symptoms other than typical GERD symptoms, which is why it is important to see a doctor if GERD symptoms are persistent.
Barrett's esophagus will progress through stages in the development of esophageal cancer. The stages include low grade dysplasia to high grade dysplasia then to esophageal cancer. The progression through these stages may take months to years. Once dysplasia is identified intervention is highly recommended.
Treatment Options for Barrett's Esophagus
There are a variety of treatment and management options available for individuals who have Barrett's esophagus. Each patient should work with their physician to develop the treatment plan that is best for them, taking into consideration the condition's severity, the pros and cons of each option and the patient's individual preferences and needs. For example:
- In some cases, surveillance with periodic endoscopy and biopsy is the treatment option of choice to monitor the extent to which Barrett's esophagus is progressing.
- If Barrett's esophagus has progressed to esophageal cancer, surgery to remove the esophagus may be necessary.
- Endoscopy has greatly advanced the diagnostic and treatment options available for Barrett's esophagus patients. Endoscopy allows physicians to examine the esophagus and perform treatment procedures non-surgically.
Radiofrequency Ablation Therapy
The Center for Advanced Endoscopy at Beth Israel Deaconess Medical Center was the first in Boston to offer radiofrequency ablation therapy for the treatment of Barrett's esophagus. This FDA-cleared, minimally invasive, outpatient endoscopic procedure delivers heat energy in a very controlled and precise manner to completely remove damaged tissue without causing damage to normal tissue and structures. Research indicates that Barrett's esophagus patients can be safely cured 90 to 100 percent of the time with radiofrequency ablation.
The American Gastroenterological Association (AGA) recently issued the AGA Medical Position Statement on the Treatment of Barrett's Esophagus, in which the organization recommends the removal of precancerous cells in patients with confirmed high-grade Barrett's esophagus utilizing endoscopic eradication therapy such as radiofrequency ablation technology. The guidelines also recommend the treatment as a therapeutic option for patients with low-grade (less advanced) Barrett's esophagus.
To learn more about the Center for Advanced Endoscopy's vast experience and expertise working with and treating individuals with Barrett's esophagus, as well as in performing endoscopic radiofrequency ablation procedures, call 617-667-4046.