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Barrett’s Esophagus and Dysplasia

Barrett’s esophagus is a serious complication of GERD, occurring in about 15 percent of people with chronic GERD symptoms. It's a condition where the cells of the esophagus change to be more like those of the small intestine and indicates disease progression. Patients with Barrett’s esophagus should be checked regularly for precancerous or cancer cells in the esophagus.

Esophageal Dysplasia (low-grade and high grade) is when the cells composing the esophageal lining have mutated into a pre-cancerous state and indicate disease. Those with dysplasia should be monitored closely and should consider therapeutic intervention to prevent the development of esophageal cancer.

Tests & Diagnosis

Sedated traditional endoscopy uses a flexible tube with a light and camera to visually inspect your esophagus, stomach, and part of the small intestine. The camera is passed into the digestive tract through your mouth.

Unsedated transnasal endoscopy is an alternative to sedated endoscopy that uses an ultrathin endoscope, passed through your nose and into the esophagus. This visual inspection does not require sedation, can be performed as part of a clinic visit, and allows you to drive yourself home afterward.

Volumetric laser endomicroscopy is a cross-sectional imaging technique that allows the physician to visualize the layers of your esophagus for more accurate biopsy sampling and tissue grading.

Biopsy collection is a standard part of an endoscopic procedure. Biopsies are very small pieces of tissue that are removed and inspected under a microscope by a specially trained pathologist. These biopsies enable tissue grading and are used to detect Barrett’s esophagus, dysplasia, and cancer.

Treatments

Radiofrequency ablation is a technique that uses electric waves to burn away areas of affected esophageal tissue and treat Barrett’s.

Cryoablation is a technique that uses extreme cold in order to freeze areas of the esophagus that has Barrett’s tissue to remove the affected area.

Endoscopic mucosal resection can be done as part of a sedated endoscopy and allows for larger areas of tissue to be removed. The physician uses a small cap mounted on the endoscope to encapsulate a small area of tissue. The tissue is banded, cut with a small snare, and removed.

Sub-mucosal dissection is similar to EMR but removes more esophageal tissue.

Minimally invasive esophagectomy for high-grade dysplasia is a process where the diseased portion of the esophagus is laparoscopically and thoracoscopically removed and replaced by a portion of the stomach.