Barrett's Esophagus

WHY TREAT BARRETT'S ESOPHAGUS
HOW IS BARRETT'S TREATED?
WHERE IS THE PROCEDURE PREFORMED?
RISKS
PRE PROCEDURE
POST PROCEDURE
 

Barrett’s esophagus is a change in the lining of the esophagus, typically in response to chronic acid damage. Barrett’s esophagus can only be diagnosed by performance of Upper Endoscopy with biopsy. Barrett’s esophagus carries the risk of deteriorating to cancer in a significant percentage of patients.

 

 

Why treat Barrett’s esophagus?

Barrett’s esophagus is treated to decrease the risk of progression to cancer.

How is Barrett’s treated?

Many methods have been investigated to eliminate (or ablate) Barrett’s esophagus: freezing (cryotherapy), laser, electrical burning (cautery), and radio-frequency energy. The best treatment currently is called Radio Frequency Ablation (RFA), which is energy delivered to precisely destroy (or ablate) the Barrett’s tissue. The advantage of this method over others is the very precise depth of energy penetration which decreases the frequency of complications.

The physicians of Eugene Gastroenterology Consultants are fully trained in using Radio Frequency Ablation to treat Barrett’s esophagus in those patients in whom ablation (or destruction) of Barrett’s esophagus is felt to be appropriate. At this time, not every patient with Barrett’s esophagus needs to undergo Radio Frequency Ablation. If you are interested in this treatment, but are not sure if you are an appropriate candidate, please make an office appointment to discuss this in detail.

Where is the procedure  performed?

Treatment of Barrett’s esophagus with radio-frequency ablation is performed at either the Oregon Endoscopy Center or Sacred Heart Medical Center – RiverBend. The size of the Barrett’s esophagus and medical complexity are two factors which may influence where the procedure is performed.

What are the risks and complications of ablation?

Since ablation is the controlled destruction of tissue, you need to understand that there are risks involved. The most common risks are: pain, bleeding, side effects of medications given for the procedure, and infection (mostly at the IV site). Less common but more serious complications include: stricture formation (narrowing of the esophagus), perforation (causing a hole in the esophagus), and aspiration (having liquid get into the airway). Strictures cause difficulty swallowing (food getting “hung up” in the chest area) and may not be apparent for weeks or months after the ablation session. Perforations lead to severe chest pain, difficulty breathing,

You may also visit http://www.barrx.com/patients-families/ for information specifically about RFA using instruments manufactured by Barrx.

Pre Procedure

When your procedure is scheduled, you will be given specific instruction for preparing for your exam.  The prep instructions vary, depending on the time of your appointment as well as other factors.  If you have any questions regarding your prep, contact our office at 541 868-9500.  Urgent concerns outside of the office hours should be directed to the on-call physician at 541 868-9500 (toll free 877 484-4501).

 

Post Procedure

  • You may experience a sore throat following the procedure which may last for several hours. You may find warms drinks very soothing. You may also take Tylenol for the minor discomfort. If your pain becomes severe, please notify your physician.
  • After ablation of Barrett’s esophagus, it is common to experience significant chest pain which may last for a number of days. Sometimes the pain is severe enough that even drinking water may be very uncomfortable. Your physician has provided prescriptions for your use for pain and control of stomach acid. Please use these as directed by your physician. The chest pain should gradually resolve over the next few days. If your pain is not responding to pain medications, lasts longer than 5 days, or is becoming worse instead of better, please do not hesitate to contact your physician.
  • You should consume only liquids for the first 24 hours after the ablation procedure. Liquids, such as Carnation Instant Breakfast, Ensure, Boost, and Slim Fast are encouraged due to the balanced nutrition. It is recommended that you consume only soft foods for the first few days after your procedure, and then advance to a regular diet as your pain subsides. Avoid highly acidic foods, such as citrus, carbonated beverages, and spicy items which may make the pain worse.
  • You may experience some gas pain since the stomach is inflated with air during the examination. This discomfort should pass with burping and with the passage of time.
  • Nausea may be caused by the presence of gas, effects of medication used for sedation, or pain. This may last for several hours; should this persist into the next day, your doctor should be notified. If you have significant vomiting, please call your physician.
  • Localized irritation of the vein (phlebitis) may occur at the IV site. If you notice a red streak progressing from the IV site upward, call your physician; antibiotics may be needed.
  • Forgetfulness is normal immediately after the procedure. This is due to the use of a sedative which causes temporary amnesia. If you have any questions about your procedure which have not been addressed in your discharge papers, please call.
  • FEVER, SEVERE PAIN, DIFFICULTY BREATHING, SIGNS OF BLEEDING, OR ANY OTHER SIGNIFICANT CONCERNS SHOULD BE REPORTED TO YOUR PHYSICIAN IMMEDIATELY. PLEASE CALL EUGENE GASTROENTEROLOGY AT (541) 868-9500 AT ANY TIME. During business hours, ask to speak with your physician’s triage nurse; after hours, please ask the operator to call the on-call physician.

 

Note: The information in this section is provided as a supplement to information discussed with your healthcare provider. It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.

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