What is Radio Frequency Ablation for Barrett's Esophagus?
Barrett's esophagus typically does not "heal" on its own or revert to normal tissue, even when treated with acid reflux medications that alleviate heartburn. In a small percentage of patients, Barrett’s esophagus can progress into a precancerous state. If these precancerous cells are not eliminated, they can further progress into esophageal cancer.
To prevent this, Radiofrequency Ablation (RFA) uses targeted heat energy delivered via a specialized catheter during an upper endoscopy to burn and destroy abnormal, precancerous cells. The burned tissue sloughs off over 48 to 72 hours following the procedure. The patient is then treated with a high dose of proton pump inhibitor, a potent acid suppressive medicine, and an ulcer coating agent called sucralfate. Over a period of six to eight weeks, the area will be replaced by new, healthy lining.
Preparing for a Radio Frequency Ablation
Your physician will give you detailed instructions prior to your procedure but, typically, to prepare for your upper endoscopy radio frequency ablation, follow these steps:
No food or drink: Do not consume any solid food or liquids after midnight prior to your procedure. An empty stomach is required for safe sedation during the upper endoscopy.
Blood thinners: Inform your gastroenterologist about all medications you take. You will likely need to temporarily stop blood-thinning medications or NSAIDs (such as aspirin, Coumadin, or Plavix) days in advance.
Daily Medications: Ask your care team specifically which morning medications you are allowed to take with a tiny sip of water.
Ride Arrangement: Because you are receiving moderate sedation through anesthesia, you will be required to have a driver to drive you home. You will not be allowed to drive yourself after the procedure.
Post-procedure diet: Stock your kitchen with items for a gradual diet progression post-ablation, starting with clear liquids on day one, full liquids on days two and three, and soft foods for the first week.
How is Radio Frequency Ablation Performed?
The patient will undergo an upper endoscopy, so the doctor can carefully examine the esophagus, stomach, and the upper part of the small bowel using a camera fixed at the end of a special tube called an endoscope. The location of the Barrett’s or abnormal tissues will then be identified, and the doctor will choose the appropriate ablation catheter, fitted with a balloon or a small pad containing tiny electrodes, to pass through the endoscopy to the targeted site. The balloon inflates so the electrodes touch the diseased tissue, or a pad is placed directly against it. The device delivers a precise burst of radiofrequency heat energy, destroying a very thin layer of abnormal tissue while leaving healthy deeper layers unharmed. The doctor then removes the catheter and endoscope. The entire process takes about 30-60 minutes.
On average, one to three treatments are needed to completely remove all of the abnormal tissue and follow up endoscopies in two-three-month intervals to evaluate if further treatments are needed.
Currently, Radio Frequency Ablation for Barrett’s Esophagus is only performed by Dr. Travis F. Wiggins.