Treatment for Barrett’s esophagus depends on the level of dysplasia (precancerous cells) and severity of gastroesophageal reflux disease (GERD) symptoms. Your gastroenterologist will discuss a plan that is right for you. Treatment for Barrett’s esophagus includes:
- Reducing acid reflux – Acid-reducing medicine can help reduce acid reflux, which may be the biggest contributor to Barrett’s esophagus and esophageal cancer.
- Surveillance – Your gastroenterologist will perform periodic endoscopic exams to check for precancerous cells in the esophagus. During the procedure, a small wire with a camera attached will be inserted from your mouth to the esophagus. Your gastroenterologist will collect small tissue samples to check for dysplasia.
New technology has emerged that allow for nonsurgical treatment of Barrett’s esophagus with dysplasia and some cases of early esophageal cancers. These procedures include:
- Radiofrequency ablation (RFA) – RFA delivers energy directly to Barrett’s and precancerous cells, causing them to die and be replaced with normal cells. This treatment option is only available to individuals with low-grade dysplasia.
- Cryoablation – Exposing Barrett’s tissue to extremely cold temperatures kills precancerous cells. This technique, which uses super cold liquid nitrogen or carbon dioxide, is similar to removing a wart. This treatment is most effective for low-grade dysplasia.
- Endoscopic mucosal resection (EMR) – Special equipment mounted to an endoscope (small wire with a camera attached) scoops out a large section of Barrett’s tissue. Your gastroenterologist may discuss this treatment if you have high-grade dysplasia.
Nonsurgical treatment is often one of the first steps in addressing precancerous cells. Your gastroenterologist will discuss the best plan for you. If Barrett’s esophagus does lead to high-grade dysplasia or esophageal cancer, there are many effective surgical options.
Individuals with severe Barrett’s esophagus and precancerous cells may require an esophagectomy, which removes part of the esophagus. During surgery, an incision will be made in your chest or abdomen to allow your surgeon to access the damaged portion of your esophagus.
Part of the esophagus will then be removed and replaced with another organ, such as the stomach or large intestine. Some individuals may be a candidate for a minimally invasive approach for an esophagectomy, which only requires a few small incisions and offers a faster recovery time.
Recovery from esophagectomy can vary across individuals and the type of procedure. You will need to stay at least one night in the intensive care unit after surgery, and you may be released or moved to a different floor for more monitoring.
Recovery usually takes six to eight weeks and includes adjusting eating habits. You may have a feeding tube for the first few weeks after surgery, and may need to eat smaller meals once the feeding tube is removed.