Treatments for Barrett’s esophagus include; medications, endoscopic ablation therapies, endoscopic mucosal resection, and surgery.
Endoscopists at Columbia use BARRX HALO technology, an advanced form of ablation that delivers heat energy in a precise and highly-controlled manner. This catheter delivers a short burst of radiofrequency energy circumferentially to the esophagus, which eliminates the abnormal Barrett’s epithelium and allows the normal squamous epithelium to regrow. It is capable of achieving complete removal of the dysplastic Barrett’s epithelium without damage to the normal underlying structures.
Our physicians are actively testing combining of radiofrequency ablation with acid suppression so a normal lining grows back with healing. Early results are highly promising, showing high efficacy for complete removal of Barrett's esophagus with a very low incidence of serious side effects. Efficacy and safety appear clearly improved compared with prior laser-based ablation therapies.
Endoscopic Mucosal Resection
Patients with Barrett's esophagus who develop a small focus of cancer can often be spared a radical surgical procedure by opting instead for endoscopic mucosal resection (EMR).
Performed through the endoscope, EMR involves injection of a solution under the abnormal area of the esophagus. Suction is then applied to create a small polyp of tissue, and a snare is used to resect the area, much like the process of removing a colon polyp. While this procedure cannot remove tissue from the entire circumference of the esophagus, EMR can be used to remove a small superficial cancer or a localized area of high-grade dysplasia.
Endoscopic ultrasound (EUS) is used to judge whether EMR is appropriate and is also effective for staging, providing definitive evidence on the depth of the tumor.