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Barrett's Esophagus

Without intervention, chronic heartburn can lead to gastrointestinal reflux disease (GERD) or Barrett's esophagus, a precursor to cancer of the esophagus.

GERD develops when the sphincter valve at the bottom of the esophagus and can no longer prevent the stomach’s digestive juices from backing up—refluxing—into the esophagus. Additionally, if you have a hiatal hernia, the lower esophageal sphincter has been pushed into the chest and can no longer prevent acid from refluxing into the esophagus. 

In severe cases of GERD — about 10 percent — a condition called Barrett’s esophagus develops. It occurs when the constant reflux of acids causes the abnormal growth of precancerous cells — dysplasia — in the esophageal lining that are similar to those found in the intestine. Because these changes greatly increase a person’s risk of developing esophageal cancer, early detection of Barrett’s esophagus is critical.

To schedule a screening for Barrett's esophagus, please call the UC Irvine Health specialists in esophageal disease at 888-717-4463

At the H.H. Chao Comprehensive Digestive Disease Center (CDDC), our UC Irvine Health esophageal specialists examine the interior of the esophagus and the upper part of the small intestine with an endoscope, a flexible catheter that is threaded down the throat and esophagus to the upper part of the small intestine.

A new technology, Cellvizio®, is revolutionizing the treatment of Barrett's esophagus and GERD by eliminating the customary delays for sample biopsies to be studied in the pathology lab. The Cellvizio system is an endoscope equipped with the world's smallest microscope. This enables physicians to examine the tissue at the cellular level then remove the precancerous tissues, all in one nonsurgical procedure.

Patients without precancerous cells may be treated with intensive antacid therapy or a surgical procedure called Nissen fundoplication, which prevents stomach acid from flowing upward.

Fundoplication is performed using laparoscopy, which requires only a few small incisions to accommodate tiny surgical instruments, a small video camera and light source.The procedure involves repairing any tear in the hiatus, the opening in the diaphragm through which the esophagus passes to the stomach, and wrapping the upper part of the stomach around the lower end of the esophagus.

Other nonsurgical treatments for Barrett's esophagus with dysplasia include:

  • Radiofrequency ablation (RFA)

This procedure is performed with a specially equipped endoscope. After being inserted into the esophagus, the device emits heat energy that destroys the abnormal cells.

  • Photodynamic therapy (PDT)

This innovative treatment begins by giving the patients a light-sensitive drug that targets precancerous cells. Two days later, an endoscopic procedure is performed in which laser light is directed at the esophagus wall. When the light hits the abnormal cells, the drug is activated, destroying them.

  • Surgical removal of the esophagus

For Barrett’s patients with advanced dysplasia, or early cancer, surgically removing the esophagus may be the only answer. In most cases, the procedure can be performed laparoscopically. Our UC Irvine Health esophageal surgeons are experts in this minimally invasive technique, which removes only the diseased tissue.

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