Don't Ignore Your Chronic Heartburn: New Treatments for Barrett's Esophagus
By Heather Maloney
Beth Israel Deaconess Medical Center Staff
Many people are plagued by pesky heartburn, especially after indulging in a spicy meal. But in some cases, what you think is just a late-night irritation may be something more serious.
Barrett's esophagus is a disorder in which the lining of the esophagus (the tube that carries food from the throat to the stomach) is damaged. The damage is caused by stomach acid that leaks back into the esophagus, commonly known as heartburn.
Barrett's esophagus itself does not cause symptoms, but the acid reflux that causes the condition results in symptoms of heartburn. In some cases, Barrett's esophagus can progress to cancer of the esophagus.
Dr. Douglas Pleskow, Co-Director of GI Endoscopy at Beth Israel Deaconess Medical Center in Boston, if you suffer from Barrett's esophagus, your risk for developing esophageal cancer is about 15 times higher than the general population.
"The rate of esophageal cancer is six times what it was in the 1970s, though we don't know why," Dr. Pleskow says. "White males with longstanding heartburn are at greatest risk."
The severity of this form of cancer requires early diagnosis and treatment. "We really want to diagnose this before people start having symptoms," Dr. Pleskow says. "If we wait, esophageal cancer advances very quickly. The cure rate for this type of cancer is quite dismal."
The good news is that there's a new treatment for Barrett's esophagus, called radiofrequency ablation, which has proven to be very effective for many patients. BIDMC was the first in New England to offer this therapy for Barrett's esophagus.
"The cure rate using radiofrequency ablation is 80 percent," Dr. Pleskow says. "Until now, Barrett's was not curable by standard techniques."
"I think this is one of most exciting advances in GI endoscopy in five years," he says. "Before, we really didn't have any therapy for this. We used to have to do surgery, but now we have an alternative."
During radiofrequency ablation, the physician uses an endoscope with a balloon catheter at its tip to destroy a thin layer of surface tissue that contains the problem cells. This allows normal tissue to grow back in the esophagus. After approximately two months, doctors can check the site and, if abnormal cells remain, can go back and repeat the procedure.
Dr. Pleskow points out that radiofrequency ablation carries very little risk and has few side effects. Some patients experience minor pain following the procedure, which is typically treated with Tylenol or an antacid. "This procedure doesn't replace surgery for everyone," he says. "But for many people, it's a good option."
So how do you know if your recurrent heartburn is something more serious? "If you have daily heartburn symptoms, or your symptoms are not well controlled with your current regimen of medications, you may be at risk," he says.
Similarly, if you suffer from the following symptoms, it could be more than just heartburn and you should contact your doctor:
- weight loss
- difficulty swallowing
- vomiting blood or black/brown fluid
- passing blood or black, tarry stools
- wheezing at night
Above content provided by Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.
Posted March 2009