Most patients with Barrett's esophagus can live relatively normal lives and do not develop cancer, so physicians typically prescribe antacids, which can help to reduce reflux but do not treat the cells that already have mutated. Doctors recommend that Barrett’s patients have an endoscopic exam every two to three years to look for signs of dysplasia – precancerous changes to cells. Dysplasia can be detected only through biopsies taken from multiple sites in the esophagus. Even with biopsies, though, cancer cells can go undetected.
Besides monitoring for dysplasia, the treatment for Barrett’s involves controlling symptoms of GERD. This is initialing done with anti-acid medication, but if this does not adequately control these symptoms then consideration of a laparoscopic Nissen fundoplication
should be given.
Two procedures are available to treat Barrett’s or the esophageal cells that suggest, or are diagnosed as, dysplasia:
- Radiofrequency ablation is relatively new, and promising. It uses electromagnetic coils to burn away the abnormal cells. RFA rid patients of 98 percent of the earliest form of Barrett’s cells, according to results of a study reported in Gastrointestinal Endoscopy in July 2008. Long-term data about RFA’s ability to lower cancer rates is not yet available.
- Esophagectomy, surgical removal of the esophagus, is the only treatment known to remove Barrett’s. However, because the procedure severely restricts the patient’s diet, and has a higher rate of complications and death than other gastrointestinal procedures, it is rarely recommended for cases of Barrett’s, and considered more appropriate for patients who have advanced cases of dysplasia.