Barrett's Esophagus

Treatment

The best strategy for treatment of Barrett's esophagus is to prevent the disease by controlling gastroesophageal reflux disease (GERD). For details, see treatment of GERD. Doctors may prescribe drugs that block production of acid and heal irritated tissue and recommend lifestyle changes and self-care steps, including:

• Getting more exercise
• Losing weight
• Avoiding foods that aggravate heartburn
• Stopping smoking
• Taking antacids
• Elevating the head of the bed to prevent reflux during sleep

Physicians at Mayo Clinic emphasize the importance of early detection and treatment of Barrett's-related esophageal cancer. Without expeditious treatment, this type of cancer is lethal. Ninety percent of patients diagnosed with esophageal cancer die from the disease within five years.

Endoscopy is used to monitor for the development of dysplasia and cancer. When pre-cancerous changes are detected, invasive cancer can develop with lethal rapidity. So when cancerous changes are found, the lower esophagus must either be surgically removed or the lining of the esophagus must be destroyed using endoscopy techniques such as photodynamic therapy.

Treatment Options

Photodynamic Therapy (PDT)

PDT using porfimer sodium (Photofrin) is the only approved treatment for Barrett's esophagus with high grade dysplasia. Porfimer sodium is a light-sensitizing drug (a photosynthesizer) which is administered intravenously or by mouth. The drug concentrates in the Barrett's tissues. A modified laser light is shined on the esophagus. The light activates the drug which then destroys the cells in which is it found. Read about PDT therapy.

Esophagectomy

During an esophagectomy, the surgeon removes a portion of the esophagus. The remaining esophagus is reconnected to the stomach so patients can still swallow. Mayo Clinic is one of the world's largest and most experienced medical centers for esophageal surgery. Read about esophagectomy.

Thermal Ablation

This procedure applies heat to directly burn off Barrett's lining. Strong drugs that control reflux, are prescribed to promote re-growth of normal lining.

Endoscopic Mucosal Resection

This experimental procedure is occasionally used for patients who are not good candidates for surgery, such as the people with significant heart or lung problems. It is performed through an endoscope; it involves lifting up the Barrett's lining, injecting a solution under it or applying suction and then cutting it off. Short-term follow up of patients with early cancer is promising.