Barrett’s esophagus treatments include medications for GERD, endoscopic ablative therapies, endoscopic mucosal resection, and surgery…
Your doctor may use upper gastrointestinal endoscopy with a biopsy periodically to watch for signs of cancer development. This is called surveillance.
Experts aren’t sure how often doctors should perform surveillance endoscopies. They may recommend endoscopies more frequently if you have high-grade dysplasia rather than low-grade or no dysplasia.
Three main Barrett’s esophagus causes
The first main cause of Barrett’s esophagus is long term exposure to stomach acid.
The second cause of Barrett’s is the lower esophageal sphincter (LES) not closing properly and letting the stomach acid go up into the esophagus.
The third cause of Barrett’s is inflammation of the esophagus caused by exposure to the stomach acid.
Medicines
If you have Barrett’s esophagus and gastroesophageal reflux disease (GERD), your doctor will treat you with acid-suppressing medicines called proton pump inhibitors (PPIs). These medicines may prevent further damage to your esophagus.
PPIs include
- omeprazole (Prilosec, Zegerid)
- pantoprazole (Protonix)
- rabeprazole (AcipHex)
- esomeprazole (Nexium)
- dexlansoprazole (Dexilant)
Research has not shown that medicines or surgery for GERD and Barrett’s esophagus lower your chances of developing dysplasia or esophageal adenocarcinoma.
Endoscopic ablative therapies
Endoscopic ablative therapies use different techniques to destroy the dysplasia in your esophagus. After the therapies, your body should begin making normal esophageal cells.
The most common procedures are the following:
- Photodynamic therapy. Photodynamic therapy uses a light-activated chemical called porfimer (Photofrin), an endoscope, and a laser to kill precancerous cells in your esophagus. A doctor injects porfimer into a vein in your arm, and you return 24 to 72 hours later to complete the procedure.
- Photodynamic therapy costs around $20,400 so it’s not cheap.
Complications of photodynamic therapy may include
- sensitivity of your skin and eyes to light for about 6 weeks after the procedure
- burns, swelling, pain, and scarring in nearby healthy tissue
- coughing, trouble swallowing, stomach pain, painful breathing, and shortness of breath.
- Radiofrequency ablation. Radiofrequency ablation uses radio waves to kill precancerous and cancerous cells in the Barrett’s tissue.
- Radiofrequency ablation costs almost $6,000 and you may have to have several of them done to be successful.
Complications of radiation ablation may include
- A hole in esophagus and bleeding
- chest pain
- strictures
Clinical trials have shown that complications are less common with radiofrequency ablation compared with photodynamic therapy.
Endoscopic mucosal resection
In endoscopic mucosal resection, your doctor lifts the Barrett’s tissue, injects a solution underneath or applies suction to the tissue, and then cuts the tissue off. The doctor then removes the tissue with an endoscope. You will receive local anesthesia to numb your throat and a sedative to help you relax and stay comfortable.
Before performing an endoscopic mucosal resection for cancer, your doctor will do an endoscopic ultrasound.
Complications can include bleeding or tearing of your esophagus. Doctors sometimes combine endoscopic mucosal resection with photodynamic therapy.
So the lifetime cost of all these procedures could be well over $100,000 not to mention the potential dangers…
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