Radiofrequency Ablation (RFA) for Barrett’s Esophagus

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Esophageal ablation uses radio waves to gently destroy damaged tissue and help keep Barrett’s esophagus from progressing to cancer.

Barrett’s esophagus, a possible result of long-standing acid reflux disease, also known as gastroesophageal reflux disease (GERD), increases risk for a cancer called esophageal adenocarcinoma.

As cells progress from normal to cancerous, they do it gradually. The more abnormal cells you have, the greater the risk that Barrett’s esophagus will progress to cancer. A biopsy (laboratory test) of cells, collected by endoscopy, determines the severity of the damage.

Radiofrequency esophageal ablation is the most common method of destroying the abnormal Barrett’s cells. The procedure is performed while you are sedated, and patients typically go home the same day.

The board-certified and fellowship-trained gastroenterologists at Norton Healthcare Gastroenterology have been using radiofrequency esophageal ablation to treat Barrett’s esophagus for years.

The success rate for radiofrequency esophageal ablation is high. Studies have demonstrated long-term removal tissue causing Barrett’s esophagus in 80% to 90% of the patients treated. For some patients, it may take two to three separate sessions to destroy all of the Barrett’s tissue in the esophagus. Once the abnormal cells are destroyed, healthy tissue will grow in their place after three to four weeks.

Your physician will provide you with instructions you will need to follow in the days before your procedure. Following these instructions is essential to limit surgery risks and provide the best results.

Make sure your providers are aware of all medications that you are taking, especially the following:

  • Plavix (clopidogrel)
  • Effient (prasugrel)
  • Brilinta (ticagrelor)
  • Ticlid (ticlopidine)
  • Coumadin (warfarin)
  • Eliquis (apixaban)
  • Aggrenox (aspirin/dipyridamole)
  • Pradaxa (dabigatran)
  • Persantine (dipyridamole)
  • Xarelto (rivaroxaban)

We will advise you to discontinue or adjust your dosage of these medications. We may have you consult with your primary care physician or cardiologist prior to your procedure. Also let us know of any allergies to medications.

If you are using insulin, the dosage or timing will also need to be adjusted the day of the procedure.

Do not eat anything after midnight before your procedure is scheduled.

The radiotherapy esophageal ablation procedure typically takes 20 to 25 minutes to complete. A “bite block” will be inserted into your mouth to provide a guide for the endoscope as it enters your body to the area of Barrett’s esophagus cells where a camera on the end of the endoscope allows for careful evaluation.

If any visible abnormalities (nodular, raised, ulcerated areas) are visible, an endoscopic mucosal resection (EMR) may be performed. If no abnormalities are found, the esophageal ablation will be performed in two stages — one to treat a larger area of the esophagus, then a second stage for smaller, specific areas.

After you recover from the sedation, your physician will give you a preliminary report. If any tissue was collected for biopsy, it may take several days for final results to come back from a laboratory.

Due to the effects of sedation, patients are instructed not to drive, operate machinery or make important decisions for the 24 hours following the procedure. We recommend that you have someone drive you home after surgery.

You’ll need to adopt a clear-liquid diet for the first two to three days after treatment. The nursing staff will review these and other important post-op instructions with you before you leave the hospital.

All patients feel chest discomfort and difficulty swallowing for three to five days after an esophageal ablation. Pain medications, anti-nausea medications or local anesthetics can help with symptoms and promote healing. Patients will be required to take proton pump inhibitor medication twice a day for 30 days.

Call your physician if you get a fever or have pain in the throat, chest or abdomen.

If you are unable to keep your appointment or need to reschedule, call our office at (502) 896-4711 at least 48 hours prior to your procedure.

If you are going to be late for your procedure, call the hospital’s endoscopy department. If you are scheduled at Norton Women’s & Children’s Hospital, call (502) 893-1277. If you are scheduled at Norton Brownsboro Hospital, call (502) 446-8200.

About Norton Healthcare Gastroenterology

  • Norton Cancer Institute has nine outpatient locations and multiple infusion centers in Louisville and surrounding counties and Southern Indiana. We have three radiation centers located just off major interstates, with free, self-service parking and valet parking.
  • Our gastrointestinal cancer patient navigator guides you through the treatment process. The navigator is a registered nurse and advocate for patients and families who can help coordinate scheduling to minimize your visits. The navigator provides information and support throughout your diagnosis, treatment and beyond.
  • The Norton Cancer Institute multidisciplinary approach to cancer care means you’ll have access to multiple specialists, including medical oncologists, radiation oncologists, surgical oncologists, interventional radiologists, interventional gastroenterologists, researchers, geneticists and dietitians.
  • We pull together providers from various disciplines to help identify the best treatment for you. At Norton Cancer Institute review boards, you will be considered for innovative clinical trials, immunotherapy, minimally invasive procedures, state-of-the-art radiation and advanced diagnostics.

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