Barrett's Esophagus - Treatment
Because of the connection between Barrett's esophagus and esophageal cancer, it is crucial that patients with Barrett's Esophagus see a gastroenterologist on a regular basis for endoscopic surveillance.
Long-standing gastroesophageal reflux disease (GERD) is a major cause of Barrett’s esophagus. Thus controlling GERD is the main step in the management of Barrett’s esophagus. Medical treatment is often effective. Endoscopic and surgical treatment can also be called for.
At Memorial Hermann, patients with Barrett's esophagus receive multidisciplinary care from expert gastroenterologists, pathologists, radiologists, oncologists and surgeons. Our team will recommend important lifestyle changes that will reduce acid reflux symptoms and lessen the likelihood of cancer, as well as prescribe necessary medications and discuss surgical treatment if necessary. Our state-of-the-art treatments include:
Endoscopic ablation techniques use thermal destruction of the abnormal lining cells in the esophagus and are used in patients when Barrett’s esophagus with low-grade dysplasia (abnormal cells) and high-grade dysplasia (precancerous cells). Heat is applied under control via a small balloon during an upper endoscopy, allowing the abnormal cells to be eliminated and the normal esophageal lining to grow back.
Endoscopic mucosal resection is used in patients who have Barrett’s esophagus with small areas of high-grade dysplasia (precancerous cells), or superficial cancer in the esophagus. With this technique, the part of the lining of the esophagus which contains the abnormal or cancerous cells is removed.
The aim of surgical treatment is to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) to prevent the reflux of acid and bile (non-acidic fluid) from the stomach into the esophagus and prevent further injury to the esophageal lining.
The most common procedure to restore the function of the lower esophageal sphincter and prevent reflux of acid and bile is a minimally invasive procedure called laparoscopic Nissen fundoplication and is routinely performed at Memorial Hermann. This procedure can be performed in combination with endoscopic ablation in selected patients.