Barrett’s Oesophagus Treatments

Ablation of Barrett’s oesophagus

The Halo radio-frequency device was developed to remove the abnormal inner lining (mucosa) of Barrett’s oesophagus whilst leaving the deeper muscular wall of the oesophagus intact. It appears to be effective and safe. The treatment is done during a standard endoscopy, which can be performed under sedation, and takes approximately 30 minutes. It is done as a day case and the patient does not need to remain in hospital. Most patients suffer chest discomfort and difficulty swallowing for a week or two. Occasionally patients complain of nausea for a few days as well but no other symptoms. Very occasionally, patients need to be readmitted to hospital for a couple of days in the week after treatment due to difficulties swallowing.

Ablation of dysplasia in Barrett’s oesophagus

Approximately 2% of patients develop this precancerous change every year and once high grade dysplasia develops, the risk of cancer in the next 5 years is around 50%. Eradication of high-grade dysplasia definitely prevents these patients from getting cancer. Most patients require between two or three treatments and a small number need more than this. About one in 12 patients develop a stricture (narrowing) of the oesophagus after treatment but this resolves after the oesophagus is dilated (stretched) at a further endoscopy.

Studies show that eradication rates for low grade and high grade dysplasia using HALO radiofrequency ablation are between 80-90%. We now have data for more than five years of follow up. Ten year data will be available in the next few years. We are confident already that there will be long-term benefits by using radiofrequency ablation compared to alternative methods. NICE has approved this treatment for this indication and the British Society of Gastroenterology has also endorsed it. It is now considered to be first line therapy for patients with dysplasia in Barrett’s oesophagus.

Patients with high grade dysplasia need counselling regarding other established treatment options including surgery and photodynamic therapy. For some people, it may be more appropriate not to undergo any treatment at all, particularly if they are elderly and have other illnesses. Patients should be certain that Halo radiofrequency ablation is the appropriate treatment for them before embarking on it. In particular, there is published information from NICE regarding photodynamic therapy and patients should read this before proceeding with any type of therapy for high grade dysplasia.

Ablation of low-grade dysplasia or non-dysplastic Barrett’s oesophagus.

Ask yourself these two simple questions:

• Do I have any symptoms? What are they?
• How do I make sure I don’t get cancer?

Treating Symptoms

Barrett’s oesophagus causes no symptoms at all. That’s right. Most people with the condition simply don’t know they have it. They only discover that they do have Barrett’s if they have an endoscopy test.

So why do people have an endoscopy test? Because they have symptoms!

But if they have an endoscopy, Barrett’s oesophagus must be causing the symptoms – right? WRONG!

Actually, Barrett’s oesophagus is the body’s response to bad acid reflux. It is the acid reflux that causes the symptoms.

If you are suffering with heartburn, regurgitation of food or a bitter taste in your mouth, you are almost certainly suffering with acid reflux symptoms. Other symptoms may be due to reflux but might be due to something completely different.

Only one in ten people with acid reflux develop Barrett’s oesophagus, but everyone with Barrett’s has reflux.

If you have Barrett’s syndrome, you need treatment. The treatment is almost certainly going to be for acid reflux.

If you have difficulty swallowing or pain on swallowing, you probably need to have an endoscopy test. These symptoms can also be due to acid reflux, but we know that a small number of people with Barrett’s can get cancer. These symptoms can also be a sign of cancer. If you have these symptoms, you should see your doctor and discuss whether you need an endoscopy.

If you would like to make an appointment with one of our specialists for help with your symptoms, please click here.

There are quite a few ways you can help yourself if you have Barrett’s disease.

These include:

• Reducing your acid reflux
• Diet
• Support groups
• Raising awareness

• Firstly, consider a diet which reduces your acid reflux.
• Secondly, a diet which is high in fruits and vegetables reduces cancer risk (see here as an example fruits and vegetables reduces cancer .) If you search the web, you will realize that the same diets also reduce heart disease and stroke risk!
• Reduce the amount of alcohol you drink. Alcohol is implicated in both acid reflux and oesophageal cancer

Support Groups

There are a number of charities around the UK which are run by sufferers for sufferers. Here are links to a few of them

• Heartburn Cancer Awareness and Support (H-CAS). This charity has an on-line patient forum.
• Barrett’s Oesophagus Campaign (BOC) This charity has an on-line patient forum.
• Fighting Oesophageal Reflux Together (FORT)