May 18, 2017

Treating Barrett’s esophagus: Radio-frequency (RF) ablation

General Overview

RF ablation is an outpatient procedure that uses a special endoscopic device that delivers radio-frequency energy to the surface of the esophageal lining. During the procedure, a balloon catheter or focal catheter is placed in contact with the Barrett’s tissue. The electrodes in the catheters deliver short bursts of RF energy which heats the tissue until it is no longer alive or ablates it while leaving the underlying structures intact. Several sections or areas can be ablated during the procedure with the balloon catheter treating larger circumferential Barrett’s esophagus and the focal catheter treating smaller areas.

What to expect after treatment: short-term and long-term

After the procedure, patients may experience some chest discomfort or pain and difficulty swallowing for several days. These side effects are expected and pain should be managed with your doctor. Other less frequent side effects include a narrowing of the esophagus (stricture) that can be treated with a dilation or stretching of the area, bleeding and perforation. Patients are also placed on a special diet of liquids and soft foods for several days following the procedure. Additionally, patients are prescribed twice daily PPIs to help control their reflux symptoms and promote healing of the treated area of the esophagus.

After an ablation, the esophageal lining generally takes several months to regenerate. A follow-up endoscopy is scheduled after this period to determine if all of the Barrett’s tissue was eliminated. If any Barrett’s tissue remains, additional ablation treatments may be recommended.

Patients should note, radio-frequency ablation does not fix GERD and the underlying LES issue. In addition to periodic endoscopes to check for a return of Barrett’s, patients should consult with their doctor to develop a plan for managing or eliminating their GERD.