2016-06-08 13:16:05 UTC

Barrett's Esophagus 106: Endoscopic Eradication Details

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If you have highly abnormal cells in your tissue sample, or high-grade dysplasia, your doctor may suggest an endoscopic eradication therapy. These therapies not only kill the cells that are not normal but can also cause your body to start making normal esophageal cells.

  • These therapies can be more intense than just taking daily medication and are done at a hospital or an outpatient endoscopy center by a gastroenterologist.
  • You will get medicine to numb your throat.
  • You will get medicine to help you relax, so you should not feel pain during the procedure.
  • If you have any questions about these therapies, be sure to bring them up with your doctor.

Common forms of endoscopic eradication therapies are:

Radiofrequency ablation (RFA)

  • This therapy uses radio waves to kill pre-cancer and cancerous cells in the Barrett’s tissue.
  • An electrode mounted on a balloon or an endoscope makes heat to kill the Barrett’s tissue and pre-cancer and cancerous cells.
  • Complications may include:
    • Chest pain.
    • Cuts in the lining of your esophagus.
    • Strictures (narrowing of the esophagus).

Endoscopic mucosal resection (EMR)

  • Your doctor will lift the Barrett’s tissue, inject a solution underneath or apply suction to the tissue, and then cut the tissue off. The doctor then removes the tissue with an endoscope. 
  • Gastroenterologists do this procedure at certain hospitals and outpatient centers.
  • Before doing an endoscopic mucosal resection for cancer, your doctor will do an endoscopic ultrasound
  • Doctors sometimes combine endoscopic mucosal resection with radiofrequency ablation or photodynamic therapy.
  • Complications may include:
    • Bleeding or tearing of your esophagus.

Photodynamic therapy (PDT)

  • This therapy uses a light-activated chemical, an endoscope and a laser to kill pre-cancer cells in your esophagus.
  • A doctor injects the chemical into a vein in your arm, and you return 24 to 72 hours later to finish the procedure.
  • Complications may include:
    • Sensitivity of your skin and eyes to light for about six weeks after the procedure.
    • Burns, swelling, pain and scarring in nearby healthy tissue.
    • Coughing, trouble swallowing, stomach pain, painful breathing and trouble breathing.

©AGA, July 2016

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