Barrett’s esophagus is a precancerous condition that affects the lining of the esophagus, the tube that carries food and liquids from the mouth to the stomach.
Gastroesophageal reflux disease (GERD) is a disorder in which stomach acid and enzymes cause injury to the lining of the esophagus, resulting in symptoms such as heartburn, regurgitation and chest pain. In some patients the normal cells of the esophagus are damaged and over time this damage can result in inflammation and genetic changes that cause the cells to become altered. The tissue changes its appearance and microscopically changes (“intestinal metaplasia” or Barrett’s esophagus). If a patient has GERD symptoms more than 3 times a week, he/she should consult his/her physician. It is estimated that 13% of patients with GERD also have Barrett’s esophagus.
The diagnosis is established after performing a gastroscopy where biopsies are taken from the area of esophageal inflammation. The finding of intestinal cells in the esophagus (intestinal metaplasia) confirms the diagnosis of Barrett’s esophagus. There are different grades of Barrett’s: intestinal metaplasia, low-grade dysplasia, high-grade dysplasia and esophageal adenocarcinoma.
The joint recommendations of the medical societies indicate performing upper endoscopies with biopsy in patients with Barrett’s esophagus, regularly and for life. The frequency will be much higher in patients with dysplasia, due to the increased risk of developing cancer.
In addition to endoscopic observation approaches for Barrett’s esophagus, there are treatment options that include endoscopic and surgical therapy to completely remove Barrett’s tissue.
Among the endoscopic treatment options is radiofrequency ablation or HALO. This is a technique in which tissue is heated until it is no longer viable or alive, using heat energy that is applied in a precise and controlled manner. HALO ablation technology is able to achieve complete removal of diseased tissue without causing damage to nearby normal structures.
The treatment is performed in conjunction with upper endoscopy without the need for hospitalization and does not involve incisions. There are two types of ablation catheters: HALO 360º and HALO 90º.
The patient only spends a few hours in the hospital. After the procedure you may experience chest discomfort and difficulty swallowing for several days, treated with medication.