How is Barrett’s esophagus treated?

Your treatment depends largely on presence of symptoms and dysplasia on biopsies:

Barrett’s esophagus without dysplasia

Having Barrett’s esophagus without dysplasia means your provider didn’t detect precancerous cells. Usually, you don’t need treatment at this stage. But your healthcare provider will want to monitor the condition. You’ll need to have an upper endoscopy every two to three years.

If you have GERD, your healthcare provider may prescribe medications to treat GERD. These medicines decrease stomach acid, which can protect your esophagus from damage. Lifestyle changes, like sleeping slightly inclined and avoiding eating dinner late, often help, too.

Barrett’s esophagus with dysplasia

Dysplasia is the presence of precancerous cells. Your doctor may recommend frequent monitoring or treatment to prevent cancer from developing.

Low-grade dysplasia

Low-grade dysplasia means you have some abnormal cells, but the majority aren’t affected. In this case, you may just need frequent checks to see if more changes occur. Expect to undergo an upper endoscopy every six months to a year. Ablation therapy is also recommended in select patients.

High-grade dysplasia

High-grade dysplasia indicates a substantial change in your esophagus lining. With this diagnosis, cancer is more likely. You may need to repeat upper endoscopies more often to look for cancer. Your provider may also recommend treatment, which focuses on removing the damaged tissue and includes:

  • Radiofrequency ablation: This is the most common procedure. It burns off abnormal tissue using radio waves, which generate heat.
  • Cryotherapy: Healthcare providers use liquid nitrogen to freeze diseased parts of the esophagus lining so it will slough off (shed). The process is similar to how dermatologists “freeze off” a wart.
  • Endoscopic mucosal resection: Using an endoscope, your provider can remove precancerous spots on the esophagus lining.
  • Surgery: If you have severe dysplasia or esophageal cancer, your provider may recommend an esophagectomy, a surgery to remove all or part of the esophagus.

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