Treatment for Barrett’s oesophagus includes medicines to stop stomach acid, and treatment to remove or destroy the abnormal cells.
What is Barrett's oesophagus?
Barrett’s oesophagus means that some cells in the lining of your food pipe have started to change. In a small number of people these cells may develop into oesophageal cancer over a long period of time.
The cells lining the food pipe are normally flat. They’re called squamous cells. In Barrett's oesophagus they change into a type more like the columnar (column-shaped) cells in the lining of the small and large bowel.
The cells may grow abnormally. Doctors call this dysplasia. The dysplasia can be low grade or high grade. The grade means how abnormal the cells look under a microscope. The more abnormal they look, the higher the grade.
What is the treatment for Barrett's oesophagus?
The management of Barrett's oesophagus depends on your situation. Management options include:
- monitoring your condition - this is called surveillance
- medicines to stop stomach acid
- surgery to strengthen the food pipe valve
- removing the affected area through an endoscope - this is called endoscopic mucosal resection (EMR)
- destroying the affected area using radiofrequency ablation (RFA)
- surgery to remove the area containing the affected cells
- other treatments to destroy abnormal cells, such as light therapy (photodynamic therapy) or freezing treatment (cryotherapy)
Monitoring your Barrett's
You’ll need to see your specialist doctor regularly if you have Barrett's oesophagus.
You’ll also have regular tests called endoscopies to look inside your food pipe. This checks whether the abnormal cells are developing. It can also pick up oesophageal cancer early when treatment is usually successful.
How often you have endoscopies depends on your condition and whether it is changing. Your specialist doctor will tell you more about this.
Medicines to stop stomach acid
These medicines aim to control the symptoms of indigestion and heartburn. They include drugs called proton pump inhibitors such as omeprazole tablets.
You may need to keep taking these tablets as long as they control your symptoms. But you may be able to reduce the dose after a while.
Strengthening the food pipe valve
A surgeon can sometimes strengthen the valve at the lower end of your oesophagus. This operation is called fundoplication.
It stops acid from the stomach going back up into the oesophagus and reduces indigestion and heartburn.
An operation to remove the abnormal cells
Your doctor can remove abnormal areas or outgrowths from the lining of the food pipe or the stomach. They use a thin wire called a snare put down through the endoscope to remove the inner lining of the oesophagus. This operation is called endoscopic mucosal resection or an EMR.
Your doctor uses a long flexible tube (endoscope) with a tiny camera and light on the end to look inside your oesophagus. Then they remove the abnormal area by passing special instruments through the tube.
Radiowave treatment to destroy abnormal cells
Radiofrequency ablation (RFA) uses heat made by radiowaves to kill cancer cells. It is also called radiowave treatment.
Your doctor puts a probe down the endoscope. The probe creates an electrical current which heats the cancer cells to high temperatures and destroys them.
You may have this treatment on its own or you may have RFA after endoscopic surgery to destroy any remaining abnormal cells in the area.
These specialised treatments are not available in all hospitals across the UK.
Light treatment (photodynamic therapy)
Photodynamic therapy is also called PDT. You have a drug that makes the abnormal cells sensitive to light. Then your doctor shines a light at the abnormal area through an endoscope. The light activates the drug to kill the cells.
Freezing treatment (cryotherapy)
Cryotherapy means destroying tissue by freezing it. Your doctor puts a small tube into your throat. They use liquid nitrogen to freeze the area containing the abnormal cells. The damaged cells fall off, so normal cells can replace them.
Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.