Center for Digestive Diseases

UNM Hospitals Center
for Digestive Diseases

Address:
1001 Martin Luther King Ave. NE
Albuquerque, New Mexico 87106

Appointments:
(505)272-2530 or
(505)925-6000

Facsimile:
UNMH: (505)272-6839
CDD: (505)925-7849

Radiofrequency Ablation of Barrett's esophagus


What is radiofrequency ablation of Barrett's esophagus?

Radiofrequency ablation (RFA) of Barrett’s esophagus is a procedure that uses a catheter in the esophagus with a special balloon to create a superficial burn that destroys Barrett’s esophagus.  The procedure is performed during an upper endoscopy (EGD, esophagogastroduodenoscopy) and general anesthesia is often used. 


Why is radiofrequency ablation performed?

Barrett’s esophagus is a condition in which the lining of the esophagus changes to become similar to that of the small intestine. This lining can undergo malignant transformation (can become cancerous).  Patients with Barrett’s esophagus are often enrolled in a program of regular surveillance upper endoscopy with biopsy sampling of involved Barrett’s esophagus in order to catch early precancerous changes. Once precancerous changes are detected on biopsy, your doctor may recommend to perform radiofrequency ablation (RFA) to destroy the involved Barrett’s esophagus.  By performing this procedure the risk of developing esophageal cancer is decreased.


What preparation is required?

An empty stomach allows for the best and safest examination.  Therefore, you should have nothing to eat or drink for six hours before your procedure.  If you have any questions about dietary recommendations, please call the UNMH endoscopy center at 505 272 0781 (Fax: 505 925 6160).


Procedure Preparation Instructions


Can I take my current medications?

Most medications can be continued as usual, but some medications should be stopped. Please inform your doctor if you are taking blood thinners such as warfarin (Coumadin), enoxaparin (lovenox) or clopidogrel (Plavix) as he or she may recommend to stop these medications.  Tell your doctor about all your medications and your allergies.  If there are any medications that you are not sure about taking, please consult your doctor beforehand or call the UNMH endoscopy center at 505 272 0781 (Fax: 505 925 6160).


What happens during radiofrequency ablation of Barrett’s esophagus?

Radiofrequency ablation (RFA) is performed during upper endoscopy and is an outpatient procedure that is well tolerated.  Usually general anesthesia is used during this procedure to ensure safety and accuracy.  An anesthesiologist or nurse anesthetist administers the anesthesia during the procedure.   Occasionally conscious sedation with an experienced nurse is used for the procedure. You will lie on your side while the doctor slowly inserts a flexible endoscope through your mouth and advances the endoscope to the first part of your small intestine.  The doctor will examine the lining again as he or she slowly withdraws the endoscope. A special catheter with the ablation balloon on it is passed into the esophagus and inflated so the electrodes touch the wall of the esophagus. Energy is released, creating a shallow burn, which destroys the Barrett’s esophagus without harming the tissue underneath. The treated area is then gently cleaned with a plastic cap on the end of the endoscope to remove any loose tissue and the area of Barrett’s esophagus is treated a second time with the RFA balloon.  The procedure itself usually takes approximately 45 minutes, although you should plan to be at our endoscopy center for approximately three hours. This will include the registration, preparation, procedure and recovery.


What happens after radiofrequency ablation of Barrett’s esophagus?

The doctor will explain the results to you.  If biopsies were performed, your doctor will send you a letter with those results within 1-2 weeks. Due to the use of general anesthesia or sedatives during your procedure someone will need to drive you home from the endoscopy center and stay with you. Even if you feel alert, your reflexes and judgment may be impaired. You will not be able to work for the rest of the day. In most cases you will be able to eat after the examination, but occasionally the doctor will recommend a limited diet.


What are possible complications of radiofrequency ablation of Barrett’s esophagus?

Radiofrequency ablation of Barrett’s esophagus is generally safe when performed by a gastroenterologist trained and experienced in these procedures. Chest discomfort may occur after the procedure. Other possible complications include lacerations (shallow tears) of the esophagus which may bleed.  Occasionally patients have difficulty swallowing after the procedure and rarely patients develop a stricture (narrowing) that needs dilation with a special balloon.   Possible complications include perforation or tear of the gastrointestinal tract, bleeding, reactions to the sedatives or complications of heart of lung disease.  If perforation occurs your doctor will recommend hospitalization, antibiotics and possibly surgery.  Bleeding usually stops on its own or can be controlled during the endoscopy. You will be monitored by an anesthesiologist, nurse anesthetist or registered nurse throughout the procedure for any problems with sedation, breathing or heart problems.  Contact your doctor if you notice severe chest pain, trouble swallowing, abdominal pain, fever, chills, vomiting or passage of dark tarry stools.


Dedicated Specialists in this procedure:

Dr. Arun Pillai (Director
Dr. Gulshan Parasher