By: Laurie Edwards for Reflux1
Until recently, a conversation about Barrett’s esophagus could be wrapped up in just a few words: People with gastroesophageal reflux disease (GERD) can develop this incurable condition, and having Barrett’s esophagus means facing an increased risk of esophageal cancer.
But it isn’t as cut and dried – or, luckily, as grim – as that. Armed with new technology and better understanding of the condition, experts have a lot more options for patients that go beyond the traditional “watchful waiting” approach to diagnosis and treatment.
| Get a handle on your GERD to prevent Barrett’s esophagus: |
People with daily heartburn for more than five years may be at risk for Barrett’s esophagus, so monitor your symptoms closely and speak to a doctor if you think you may be at risk.
Simple lifestyle choices can help reduce inflammation: Avoid overly greasy or fatty foods and try and cut back on caffeine and alcohol.
Experts recommend that you do not eat within three hours of going to bed to help minimize GI discomfort.
In fact, one procedure abandons the practice of looking altogether and instead ablates diseased tissue so it can be replaced with healthy cells, providing treatment of Barrett’s esophagus.
So what’s at stake for patients? Well, for starters, an estimated 25 million Americans suffer from esophageal disease; the most common culprits are the frequent bouts of heartburn, indigestion and discomfort that typify GERD.
How does Barrett’s esophagus fit into this scenario? Between 5 and 15 percent of severe GERD patients may have Barrett’s esophagus. In this condition, cells that line the esophagus, known as squamous cells, are damaged by the acid reflux from GERD and change into abnormal cells, specialized columnar cells that are not normally found in the human body.
These abnormal cells increase the likelihood of cancer; all told, about 5 to 10 percent of people with this condition develop esophageal cancer. According to the American Gastroenterological Association, esophageal cancer caused by this acid damage – called adenocarcinoma – is one of the fastest-increasing types of cancer in the country.
These abnormal cells will not revert back to squamous cells, essentially making Barrett’s esophagus incurable. The key is to prevent further damage to the esophagus through a combination of medications that reduce acid and close monitoring of the esophagus for signs of cancer.
One of the biggest advances in the field of esophageal cancer is the laparoscopic inversion esophagectomy (LIE), a much less invasive and more precise way to view the esophagus. In more traditional procedures, surgeons would cut through the chest. Now, using fibro-optic instruments and innovative points of entry, the LIE is a quicker, more painless and more effective way to see what’s going on.
The benefit belongs to both physicians and patients. “They recover faster with less pain, fewer complications and smaller scars,” said Dr. John G. Hunter of the Oregon Health and Science University Digestive Health Center. Hunter and his colleagues developed the new procedure, which for decades had been considered too technically difficult for most to perform.
“I’ve had haircuts that were more memorable,” said Ben Garcia of Chicago, commenting on another exciting new innovation in esophageal care, the PillCam ESO. Just like it sounds, the PillCam is a camera in a capsule that is swallowed with just a small amount of water.
Taking up to 14 images per second, as the PillCam ESO makes it way down the esophagus it captures more than 2,500 pictures. This technology is sorely needed, given that many patients, fearful of the traditional endoscopy – snaking a tube down the throat into the esophagus – simply refrain from getting tested.
Unlike traditional endoscopies, patients don’t need to be sedated with the PillCam ESO. Most leave the doctor's office within 30 minutes of the procedure and can return to work, school or their normal routine right away, often with the test results in hand.
One of the most exciting innovations is a device that goes beyond the somewhat limited scope of endoscopies altogether. BÂRRX Medical has developed a device that actually removes the layer of esophageal tissue where Barrett’s esophagus cells are found, allowing healthy tissue to grow in its place.
Current data suggests that half of all Barrett’s patients who have the dilation and ablation procedure are cured within three months, a promising nod towards the future of this disease.