Barrett's Esophagus
Treatments

Treatment of Barrett's esophagus depends on the condition's severity, the grade of dysplasia and the patient's overall health.

The first line of treatment is often surveillance and medication. If the biopsy shows no or even low-grade dysplasia, we may simply monitor the patient for changes. That may mean a follow-up endoscopy in six months to a year and, for some patients, daily medication.

For Bartlett's esophagus, the most common type of drug therapy is proton pump inhibitors, or PPIs. These medications are designed to treat GERD and work by suppressing the stomach's acid production. Less stomach acid means less damage to the esophagus. PPIs are best taken short term. Examples of common PPIs include:

• Omeprazole (Prilosec, Zegerid)
• Lansoprazole (Prevacid)
• Pantoprazole (Protonix)
• Rabeprazole (AcipHex)
• Esomeprazole (Nexium)
• Dexlansoprazole (Dexilant)

If GERD symptoms don't respond to medication or if the patient has high-grade dysplasia, the doctor may recommend an endoscopic procedure to remove or destroy the abnormal cells or dysplasia. The approach depends on the patient and how far the Barrett's esophagus has progressed. Three common procedures are:

• Esophageal mucosal resection: The doctor lifts the damaged tissue, injects a solution underneath to act as a cushion, and removes the affected tissue using a snare or suction cup.
• Endoscopic submucosal dissection: The doctor injects a solution under the targeted area, then dissects the area with a high-tech knife. This technique allows for the removal of larger and potentially deeper lesions.
• Radiofrequency ablation: This approach uses radio waves to heat and kill pre-cancerous and/or cancerous cells.

The last and final step for treating Barrett's esophagus is the surgical removal of the damaged sections of the esophagus, a procedure called esophagectomy. Afterward, the surgeon rebuilds the esophagus from part of the stomach or large intestine.