What is radiofrequency ablation for Barrett’s esophagus?

Barrett’s Esophagus

Patients with chronic acid reflux have an increased risk in developing a condition called Barrett’s esophagus. This occurs when the acid and enzymes in the stomach damage the esophageal lining. Some patients develop heartburn, regurgitation, and even chest pain.

In some patients, this damage can cause the cells to change from esophageal cells to intestinal cells. If this change occurs, the condition is called Barrett’s esophagus. At the time of your prior endoscopy, your physician obtained biopsies of your esophagus. These were sent to the lab and examined under a microscope. A confirmation of the diagnosis and staging was done.

Radiofrequency Ablation

Ablation is a term that refers to the use of heat to cause tissue death of unwanted tissue. Barrx™ ablation delivers radiofrequency energy or heat to cause this tissue death. The special device is placed on the end of the endoscope and introduced into the esophagus. The determined area is “burned” at precise time intervals and specific locations to ablate and remove the abnormal and unwanted cells.

Before the Procedure

It is important that you follow all instructions given to you by your doctor’s office. Generally you may be asked to temporarily stop taking certain blood thinning medications such as aspirin, Coumadin, or Plavix. Your doctor will have given you a few prescriptions to fill prior to the day of your ablation. You should bring these actual medications, along with a list of your other medications, with you on the day of the procedure.

You will not be able to eat or drink anything after midnight prior to the procedure. You will be given IV medication to make you sleepy. These medications may last in your system after you are discharged. It is important to arrange to have someone with you to take you home. You will not be able to drive yourself home after the procedure.

The Day of the Procedure

This procedure is usually performed in an outpatient setting. After you check in a nurse will bring you into the admitting area. The nurse will obtain a brief history, get a list of your medications, obtained your vital signs and place an IV catheter. The physician will come in to speak with you, answer any questions you may have, and ask you to sign the consent form. You will then be escorted into the procedure room. Monitors are placed to observe your heart rate, blood pressure and breathing throughout the procedure. Once you are sleep, the doctor will start the procedure and ablate the necessary tissue. Following the procedure you will be taken back to the recovery area. Once you are awake, you will be given a solution to swallow to help decrease any chest discomfort or pain you may have. Following the procedure it is common to have chest pain and therefore it is important to follow the medication regimen prescribed by your doctor after the procedure.

After the Procedure

It is very common to experience significant chest pain which may last for a number of days. Sometimes the pain is severe enough that even drinking water may be very uncomfortable. For 48 hours after the procedure, you should consume a full liquid-only diet. Then for the next 5 to 7 days you may advance to a soft food diet and afterwards to a regular diet as tolerated.

Also, your physician has provided prescriptions for your use for pain and control of stomach acid. Please use these as directed by your physician. The chest pain should gradually resolve over the next few days. If your pain is not responding to pain medications, lasts longer than 5 days, or is becoming worse instead of better, please do not hesitate to contact your physician.
Medications after the Procedure:

You may be given 3 additional prescriptions:

1. 2% viscous lidocaine/Maalox, 30 ml by mouth every 4 to 6 hours as needed for chest discomfort
2. Sucralfate suspension, 10 ml by mouth before meals as needed to coat your esophagus
3. Ranitidine 150 mg every night at bedtime for 2 weeks after the procedure

Continue your acid reducing medicine (Nexium, Prilosec, Pantoprazole, Protonix, etc.) twice daily for the entire duration of your RFA treatments.

You should avoid aspirin, Motrin, Advil, Aleve, ibuprofen or any other non-steroidal anti-inflammatory drugs (NSAIDS) for 1 week following your procedure.