Barrett's esophagus is a precancerous condition that develops in approximately 10% of patients who have gastroesophageal reflux disease (GERD). In Barrett's esophagus, the normal cells that line the esophagus, called squamous cells, turn into a type of cell called specialized columnar cells or Barrett's esophagus.
Diagnosis of Barrett's esophagus involves an endoscopy procedure to look at the lining of the esophagus. A biopsy or small sampling of the suspect cells are examined.
The purpose of the endoscopy is to examine the suspect cells. The tissue sample, or biopsy, will be examined to see whether the normal squamous cells have been replaced with Barrett's cells.
Once the cells in the lining of the esophagus have turned into Barrett's cells, they will not revert back to normal. In about 5% of patients, Barrett's cells may develop abnormal changes called dysplasia. Over several years, the dysplasia may progress to adenocarcinoma (cancer) of esophagus. Patients with Barrett's esophagus are 30-40 times more likely to develop esophageal cancer than the normal population.
The BÂRRX procedure (Radiofrequency Ablation) is a new endoscopic technique used for treatment of patients with Barrett's esophagus with or without dysplasia. Barrett's esophagus without dysplasia is also called intestinal metaplasia.
During the procedure, the exact diameter of the esophagus is measured using an automated dilation catheter. Then, using a proper sized ablation catheter, energy is delivered to a circumferential segment of the Barrett's esophagus. The energy is adjusted to allow a limited depth of injury to destroy the Barrett's cells without destroying the normal tissue in the deeper layer. The ablation may be repeated until the entire length of the Barrett's segment is treated.
The procedure is performed on an outpatient basis under moderate sedation or anesthesia. Typically, the procedure takes about 15-20 minutes and is well tolerated by patients.
About three months after the treatment, patients need to have an endoscopy with biopsies performed to evaluate the effectiveness of the treatment.