RFA therapy is a minimally invasive, safe, and effective method of removing precancerous cells from the lining of the esophagus. Heat energy is delivered via a catheter to the lining of the esophagus which ablates, or eliminates, the abnormal tissue found in a condition called Barrett’s esophagus.
Barrett’s esophagus is a precancerous condition occurring in the lining of the esophagus which can lead to esophageal cancer if left untreated. It is caused by chronic acid reflux. Symptoms of acid reflux include heartburn, chronic cough, and chest pain, among others. Barrett’s esophagus is diagnosed by an upper endoscopy.
The RFA procedure uses a standard upper endoscope, and you should have a similar experience to the upper endoscopy you had to diagnose Barrett’s esophagus. While you are sedated, and with an endoscope in place, a balloon catheter or mounted ablation tool delivers a rapid burst of heat energy to the lining of the esophagus where the Barrett’s tissue is located. With the Barrett’s tissue removed, new esophageal cells will fill in the treatment area. The procedure typically takes less than 30 minutes and is performed without incisions.
Follow the instructions provided by your doctor. You will be instructed to avoid eating and drinking after midnight the day before the procedure. You should arrange for someone to drive you home after the procedure. Your doctor will provide instructions if you regularly take aspirin or blood thinning medication.
The RFA procedure is performed in an outpatient setting. When you arrive at our facility, you will be greeted by our office staff who will facilitate the check-in process. Our medical staff will then guide you to the procedure area where you will meet with your doctor and review treatment goals. You will then be sedated by our anesthesia team and the procedure will typically be less than 30 minutes in length. You will be monitored for a brief period of time afterwards. You will receive diet and medication instructions before going home. Since you will receive sedatives for the procedure, YOU MUST ARRANGE FOR A RIDE HOME.
It is very important to follow the discharge instructions provided by your doctor in order to ensure a favorable outcome. The majority of patients feel well after the procedure. Some individuals may have minor discomfort in the throat or chest, which is managed with medication and will usually dissipate within a few days. Contact your doctor immediately if you experience significant chest pain, difficulty swallowing, fever, bleeding, abdominal pain, difficulty breathing, or vomiting. After the initial treatment, you doctor will schedule a follow-up appointment in 2-3 months to evaluate your response to the ablation therapy and perform an additional treatment if necessary.
RFA has an excellent safety profile. The risks of the procedure are similar to a standard upper endoscopy, which include bleeding, infection, mucosal laceration/perforation, and risks associated with sedation. The stricture rate is less than 6%.
The number of treatments will depend on the length and severity of the Barrett’s tissue. Patients usually require an average of 3 to 4 procedures, performed every 2-3 months, to achieve successful results and have complete remission of Barrett’s esophagus.
There are over 40 peer-reviewed publications which have studied the success of RFA for the treatment of Barrett’s esophagus. The cure rates have ranged from 77-100%. In the larger studies to date, there was complete eradication of non-dysplastic Barrett’s in 98.4% of patients. Evaluation of patients with more severe types of Barrett’s, called dysplastic Barrett’s esophagus, found the success rate RFA to be over 90%. Durability testing found that 92% of patients were still disease free 5 years after initial treatment.
The staff of Connecticut GI will be happy to assist you in finding the information you need to better understand Barrett’s esophagus and RFA.
Contact us! Connecticut GI has highly skilled physicians who can review your medical issues and discuss the appropriate treatment options.
IMPORTANT REMINDER:The preceding information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.