Radiofrequency Ablation: What You Should Expect

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Radiofrequency ablation (RFA) is a procedure that utilizes radio waves to destroy diseased tissue. Here’s what you need to know if you are preparing for the procedure. 

When it’s used

Radiofrequency ablation can be used during an upper endoscopy to treat Barrett’s esophagus. People with Barrett’s esophagus have an increased risk of esophageal cancer, and RFA can eliminate this risk by destroying pre-cancerous tissue in the esophagus. Patients with both high and low grade dysplasia should almost always pursue radiofrequency ablation. It has an 80-90% success rate in removing Barrett’s esophagus long-term. There is a chance that Barrett’s can develop again after a successful procedure. However, repeat treatments are effective and often able to eliminate abnormal tissues entirely. 

Preparing for Radiofrequency Ablation

To prepare for RFA, your physician will discuss preoperative steps with you. First, you will need to talk to them about medications you are taking that could be a risk factor. For example, blood-thinning medications can increase the risk of excessive bleeding during the procedure. Additionally, if you use insulin, you may need to adjust dosage or timing leading up to the RFA. Your doctor will also ask you about any allergies to medications. You will be instructed to stop eating at midnight the day before the procedure. 

During the procedure

Before the procedure, you will be on an IV and will give your medical information in a pre-op area. An anaesthesiologist will then discuss sedation for the procedure. Then, you will go to the procedure room. Doctors will connect you to monitors that measure your heart rate, blood pressure, and blood oxygen levels.

Your doctor will perform radiofrequency ablation during an upper endoscopy. You will be on your left side. A bite block will be in your mouth to prevent damage to your teeth or the endoscope. You will be under sedation for the duration of the procedure. 

Your doctor will advance the endoscope into your esophagus and examine the Barrett’s esophagus. If they see any visible abnormalities, they may perform an endoscopic mucosal resection. This involves either injecting or banding any identified lesions and then using a snare device to capture, cut, and remove them. If this is not necessary, your doctor will perform RFA. They will inflate a balloon-catheter to make contact with the targeted area and apply heat energy for a second or so. 

After the Radiofrequency Ablation

Afterwards, you will wait in a post-op area where you can recover from the sedation while being monitored for any complications. Once you have recovered, your doctor will discuss their findings with you. Some results may take days or weeks to return. They will also give you information on any follow-up appointments. 

For the first 24 hours after the procedure, you should not drive or make important decisions due to sedative effects. Your doctor will also recommend a clear liquid diet for a few days following the treatment. 

Patients commonly feel some chest discomfort and have difficulty swallowing for a few days after the procedure. Your doctor will be prescribe medications to help with any pain or nausea. You will also need to take a proton pump inhibitor twice a day for 30 days. 

Complications

There are a few complications that can occur from the procedure. In around 6% of cases a stricture or narrowing of scar tissue develops in the esophagus. Doctors can treat this with dilation during an upper endoscopy. Another more rare complication is a tear in the esophagus, which occurs less than .02% of the time. 

Our experienced team at GHP has years of experience performing radiofrequency ablation. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Barrett’s Esophagus: Five Things You Need To Know

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Barrett’s Esophagus is a condition that develops from chronic gastroesophageal reflux disease (GERD). GERD causes stomach acid to back up into the esophagus, and over time tissue in the esophagus can change to become tissue similar to that in the intestines. This tissue change is the defining element of the condition. 

Here are 5 things you need to know about Barrett’s Esophagus. 

Causes and Risk Factors

The exact cause of Barrett’s Esophagus is not known. However, a major risk factor is having GERD symptoms for 10 years or more. While some people who develop the condition have no history of GERD, it does increase the likelihood of the condition. Additionally, men, older adults, White people, overweight people, and people who smoke or have smoked are more likely to develop it. 

Barrett’s Esophagus Symptoms

Many of the symptoms people experience with Barrett’s Esophagus are the same symptoms associated with GERD. These include frequent heartburn, difficulty swallowing, upper abdominal pain, a dry cough, and chest pain. However, many people with the condition do not have any of these symptoms. 

Diagnosis

Barrett’s Esophagus is diagnosed through a procedure called an upper endoscopy. During this procedure, a physician uses an endoscope (a flexible tube with a camera) to examine the upper gastrointestinal tract. The endoscope is fed through the mouth and gives a view of any changes in the lining of the esophagus. Then, the physician may take a tissue sample of the lining, which will later be studied for any signs of metaplastic cells that can confirm a diagnosis. Since the condition doesn’t affect all areas of the esophagus, biopsy samples are taken from multiple places on the esophagus lining. 

Complications from Barrett’s Esophagus

People with Barrett’s Esophagus have an increased chance of developing esophageal adenocarcinoma, a rare type of cancer. When their esophageal tissue is replaced with intestine-like tissue (in a process called metaplasia), if the stimuli causing the metaplasia is not removed by addressing the acid reflux, dysplasia can occur. 

Dysplasia is a process where cells develop abnormally, and can lead to cancerous growth. The extent of dysplasia is diagnosed through a biopsy. Low-grade dysplasia is when cells show a small amount of change, and high-grade dysplasia is when advanced change has occurred and may lead to cancer. As a preventative step, people with Barrett’s Esophagus are often monitored through regular exams to check for precancerous cells. Procedures like ablation can be performed on precancerous cells to prevent cancerous growth. 

Treatments

Treatment for Barrett’s Esophagus varies based on the extent of the condition. For people with no or low dysplasia, lifestyle changes like eliminating heartburn triggers and maintaining healthy weight can ease symptoms. In addition, regular check-ups are often recommended to monitor any changes over time. 

When high-grade dysplasia is present, more serious interventions may be required. These treatments include removing damaged cells through an endoscopy, surgery to remove damaged parts of the esophagus, using cold therapy to damage abnormal cells, and using light therapy to destroy damaged cells.

Our experienced team at GHP has years of experience helping people manage and treat Barrett’s Esophagus. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.