Barrett’s Esophagus Center of Excellence

Early stage esophageal cancer refers to lesions confined to the mucosa, as opposed to lesions that invade through the submucosa into the muscularis propria. Commonly referred to Stage 1 disease.

A condition in which acid-containing contents in your stomach persistently leak back up into your esophagus. This can happen when a valve at the end of your esophagus called the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Symptoms can include regurgitation, pain in the chest or heartburn, hoarseness, trouble swallowing, food stuck in your throat, dry cough or bad breath. GERD isn’t life-threatening or dangerous in itself, however long term GERD can lead to more serious health problems such as esophagitis, strictures (abnormal narrowing) of the esophagus, Barrett’s or esophageal cancer.  GERD is usually controlled with medications and lifestyle changes. If these don’t work, or if you can’t take medications for an extended period, surgery may be a solution.

Barrett’s esophagus is when the normal cells that line your esophagus turn into a different type of cell due to damage in the lining of the esophagus. The new, abnormal cells are called specialized columnar cells, or Barrett’s Esophagus. Having Barrett’s Esophagus raises your risk of getting esophageal cancer.

An esophageal stricture is an abnormal tightening or narrowing of the esophagus.

GAVE is a condition in which the blood vessels in the lining of the stomach become fragile and become prone to rupture and bleeding.  The stomach lining exhibits the characteristic stripes of a watermelon when viewed by endoscopy.

Chromoendoscopy is a technique used which involves the topical application of stains or pigments to improve tissue localization, characterization, or diagnosis during endoscopy.

A procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area in the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy if necessary.

Radiofrequency ablation, also known as BARRX or HALO procedure, is a new endoscopic technique used for the treatment of Barrett’s esophagus. It is a technique that allows radiofrequency energy to be directed to abnormal cells, limiting its tissue injury preventing deeper normal tissue involvement. The ablation may be repeated over time until the entire area of abnormal cells is resolved.

An endoscopic procedure that is used to remove small nodules, early stage cancers or segments of Barrett’s esophagus that are resistant to simple treatment.

Typically done endoscopically by stretching the esophagus with different dilators. If this technique fails to help patients become symptom free, other options may include corticosteroid injections into the esophageal stricture after dilation or temporary placement of esophageal stents.

Argon Plasma Coagulation (APC) is one type of treatment used for management of Barrett’s esophagus. This system uses argon gas to deliver thermal plasma energy to the tissue.

Esophageal manometry is a test used to evaluate how well the esophagus muscles work to transport liquids/food from your mouth into your stomach. Esophageal manometry is typically performed to evaluate the symptoms of gastric reflux, heartburn, difficulty swallowing, regurgitation, and functional chest pain. This test may also be used in preoperative evaluation for anti-reflux surgery. It can also be used to determine esophageal distance measurement needed for performing ambulatory pH/Impedance diagnostic test.

This is a catheter based test which can be done with or without sedation. It is used for evaluation of heartburn or related symptoms. Your physician will analyze results from this test to understand the root cause of your symptoms and determine appropriate treatment for you.

A miniature pH capsule about the size of a gel cap is placed and attached to the esophageal wall under anesthesia. This test is used to evaluate gastrointestinal reflux symptoms by measuring the pH in your esophagus continually for approximately 48-96 hours. This study will provide your physician with valuable information to help treat your symptoms.

Cryotherapy is a new technique that uses extreme cold to destroy Barrett’s esophagus. Liquid nitrogen, CO2 and nitrous oxide are among available sources of extreme cold. The Center uses the through-the-scope Cryoballoon Focal Ablation system that consists of a battery powered handle, a balloon catheter and a cartridge that stores the liquid nitrous oxide. The system is programmed to deliver a preset amount of fluid inside the balloon after it is positioned within the Barrett segment during a routine endoscopy. The cryotherapy is maintained within the balloon catheter, eliminating the need for venting of the gas from the esophagus and stomach. The system delivers more accurate treatment and is safer to apply in an outpatient procedure.