When you eat or drink, your esophagus carries what you swallow to your stomach. If the contents of your stomach come back up into your esophagus, it’s called acid reflux. If that happens regularly over an extended period of time, it’s known as gastroesophageal reflux disease, or GERD.
As uncomfortable and inconvenient as GERD is, there’s an underlying danger that’s far more ominous. It can lead to something called Barrett’s esophagus — and that can lead to cancer. But if you treat Barrett’s esophagus in time, you can prevent cancer.
All the acid and enzymes that come with acid reflux can damage your esophagus, turning the tissue lining your esophagus into intestinal tissue. That’s Barrett’s esophagus — and when those abnormal cells grow in a rapid and uncontrolled manner, they invade the deeper layers of your esophagus, resulting in cancer of the esophagus, or esophageal adenocarcinoma (EAC). This cancer can also spread beyond the esophagus.
Cancer of the esophagus is the most rapidly rising cancer in the U.S. It’s often incurable because it’s frequently discovered at a late stage — even with aggressive therapy, the 5-year survival rate from EAC is only about 17%.
If you have recurring acid reflux or GERD, you should absolutely be tested for the presence of Barrett’s Esophagus. (If you’re not sure whether you actually have recurring acid reflux or GERD, our team can help you find out as a first step).
To find out if you have Barrett’s Esophagus, we would perform a very standard procedure called an upper endoscopy. A very thin fiber optic tube is used to capture images of the lining of the esophagus. It’s a very safe, routine outpatient procedure performed at a local hospital under conscious sedation with minimal discomfort.
The endoscopy will show us two things. First, it allows us to see the tissue lining the esophagus. If it appears darker in color than is normal, that suggests that the intestinal-type tissue seen in Barrett’s esophagus is present. If such tissue is identified, then a biopsy is performed on tiny samples of that tissue obtained during the procedure. Those samples are examined under a microscope for the presence of a very specific type of cell called a goblet cell.
The endoscopy must show both the darker tissue and goblet cells for a diagnosis of Barrett’s Esophagus. If present, it will also allow us to determine how severe the Barrett’s Esophagus is, and whether any cancer is already present.
There are also new, tiny capsules with built-in cameras that can be swallowed. As it passes through your digestive system, the camera transmits video to a recorder on your belt. Your doctor can look at the video to see if there are changes in the lining of the esophagus. This approach, however, does not allow for biopsy tissue samples to be taken.
The team at Gastroenterology of Southern Indiana is one of the few in the region to offer radiofrequency ablation (RFA) therapy to treat Barrett’s Esophagus — using radio waves to remove diseased tissue in your esophagus, minimizing injury to healthy tissue. RFA has a lower rate of complications than other kinds of ablation therapy. (Ablation means getting rid of abnormal tissue.)
In an outpatient procedure at a local hospital, you’re sedated and another endoscopy is performed, this time inserting a tiny device into the esophagus that delivers a controlled level of energy and power to remove a thin layer of diseased tissue.
Larger areas of Barrett’s tissue are treated with a balloon-mounted catheter. Smaller areas are treated with an endoscope-mounted catheter. A clinical trial showed that 98.4% of people were free of Barrett’s at a follow-up exam 30 months after two or three RFA treatments. Studies show that when the Barrett’s tissue is removed, it is typically replaced by normal, healthy tissue within three to four weeks.
But we don’t stop there. Once the procedure is completed, we can also treat your acid reflux or GERD to help prevent a recurrence.