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Balloon-based radiofrequency ablation, invented by Ganz, Stern, and Zelickson in 1999, is a new treatment modality for the treatment of Barrett's esophagus and dysplasia and has been the subject of numerous published clinical trials.
Chronic inflammation caused by H. pylori infection in the stomach and GERD in the esophagus are seen as the primary instigators of metaplasia and subsequent adenocarcinoma formation. Initially, the transformed epithelium resembles the small intestine lining; in the later stages it resembles the lining of the colon .
Some people also experience a sensation known as globus esophagus, where it feels as if a ball is lodged in the lower part of the esophagus. The following are additional diseases and conditions that affect the esophagus: Achalasia [1] Acute esophageal necrosis; Barrett's esophagus; Boerhaave syndrome; Caustic injury to the esophagus; Chagas disease
Some physicians advocate either once-in-a-lifetime or 5- to 10-yearly endoscopy for people with longstanding GERD, to evaluate the possible presence of dysplasia or Barrett's esophagus. [45] Biopsies performed during gastroscopy may show: Edema and basal hyperplasia (nonspecific inflammatory changes) Lymphocytic inflammation (nonspecific)
People with Barrett's esophagus (a change in the cells lining the lower esophagus) are at much higher risk, [55] and may receive regular endoscopic screening for the early signs of cancer. [56] Because the benefit of screening for adenocarcinoma in people without symptoms is unclear, [2] it is not recommended in the United States. [1]
A micrograph of intestinalized epithelium in Barrett's esophagus. Micrograph showing apocrine metaplasia of the breast with typical features [3] H&E stain. Barrett's esophagus is an abnormal change in the cells of the lower esophagus, thought to be caused by damage from chronic stomach acid exposure.
Both of these features impair the ability of the esophagus to empty contents into the stomach. Patients usually complain of dysphagia to both solids and liquids. Dysphagia to liquids, in particular, is a characteristic of achalasia. Other symptoms of achalasia include regurgitation, night coughing, chest pain, weight loss, and heartburn.
Often treatment for esophageal inlet patch is not necessary. However, when symptoms occur, treatment may consist of ablation. [1] Ablation may be performed with argon plasma coagulation or radiofrequency ablation. [1] When performed by an experienced physician, side effects from ablation appear to be negligible. [1]