This information will help you prepare for your BarrxTM ablation procedure at Memorial Sloan Kettering Cancer Center (MSK).
BarrxTM ablation is a procedure used to treat Barrett’s esophagus, a condition that can result from chronic heartburn or gastroesophageal reflux disease (GERD). This procedure uses radiofrequency energy (heat) to destroy the abnormal cells during an upper endoscopy procedure. Destroying these cells can prevent the tissue from developing into cancer. Once the abnormal cells are destroyed, new healthy cells can replace them.
1 Week Before Your Procedure
Ask about your medications
You may need to stop taking some of your medication before your procedure. We have included some common examples below.
- If you take medication to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask the doctor who prescribes it for you when to stop taking it. Some examples are aspirin, warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®).
- If you take insulin or other medications for diabetes, you may need to change the dose. Ask the doctor who prescribes your diabetes medicine what you should do the morning of your procedure.
Get a letter from your doctor, if necessary
If you have an automatic implantable cardioverter-defibrillator (AICD), you will need to get a clearance letter from your cardiologist before your procedure.
Arrange for someone to take you home
You must have someone 18 years or older take you home after your procedure. Please call one of the agencies below if you do not have someone who can do this. They will help find someone to take you home.
In New York:
Partners in Care (888) 735-8913
Prime Care (212) 944-0244
In New York or New Jersey:
Caring People (877) 227-4649
3 Days Before Your Procedure
You will receive a telephone call from an endoscopy nurse. He or she will review the instructions in this guide with you and ask you questions about your medical history. The nurse will also review your medications and tell you which to take the morning of your procedure. Use the space below to write them down.
The Day Before Your Procedure
A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If you are scheduled for your procedure on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call (212) 639-5014.
If you need to cancel your procedure for any reason please call the doctor who scheduled it for you.
Do not eat or drink anything after midnight the night before your procedure. This includes water, gum, and hard candy.
The Day of Your Procedure
Things to remember
- Do not eat or drink anything the morning of your surgery. This includes water, gum, and hard candy.
- Take only the medications your doctor told you to take the morning of your procedure. You may have written them down above. Take them with a few sips of water.
- Do not put on any lotion, cream, powder, deodorant, make-up, or perfume.
- Remove any jewelry, including body piercings.
- Leave all valuables, such as credit cards and jewelry, at home.
- If you wear contacts, wear your glasses instead.
What to bring with you
- A list of the medications you take at home, including the dose
- Your rescule inhaler (such as albuterol for asthma), if you have one
- A case for your glasses
- Your Health Care Proxy form, if you have completed one
Where to park
Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that goes from the garage into the hospital. For questions about prices, call (212) 639-2338. There are also commercial garages nearby, on East 69th Street between First and Second Avenues and on East 65th Street between First and Second Avenues.
Where to go
Your procedure will take place in the Endoscopy Suite at MSK, which is located at 1275 York Avenue. Take the M elevator to the 2nd floor.
What to expect
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.
After changing into a hospital gown, you will meet your nurse. He or she will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first you will receive fluids through the IV, but it will be used later to give you anesthesia (medication to make you sleepy). Your doctor will explain the procedure, and answer any questions you have.
When it's time for your procedure, you will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. A mouth guard will be placed over your teeth to protect them.
You will receive anesthesia through your IV, which will make you fall asleep. Once you are asleep, your doctor will pass the endoscope (flexible tube) through your mouth and down your esophagus. While looking through the endoscope your doctor will treat the abnormal cells with radiofrequency ablation, which kills them. The procedure takes 30 to 90 minutes, depending on the size of the area being treated.
After Your Procedure
In the recovery room
You will wake up in the recovery room. Your nurse will continue to monitor your heart, breathing, and blood pressure. You may have a sore throat, pain and/or difficulty swallowing, and nausea and/or vomiting. Your nurse will help you manage these symptoms.
Once you are fully awake, your nurse will remove your IV. If you have someone waiting with you, your nurse will explain your discharge instructions to both of you before you go home.
After your BarrxTM ablation, you may have a sore throat, chest discomfort, difficulty or pain with swallowing, nausea, and/or vomiting. These symptoms will improve each day.
- Do not drink alcohol for 24 hours after your procedure.
- For first 2 days after your procedure, only drink liquids. Do not eat anything.
- For the 5 days after that, eat a diet of only soft foods. Examples include liquids, mashed potatoes, pasta, oatmeal, applesauce, scrambled eggs, yogurt, pudding, and ice cream.
- Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 week after your procedure. Ibuprofen (Motrin®, Advil®), naproxen (Aleve®), and aspirin are examples of NSAIDs. For more information, ask your nurse for the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or access it online at www.mskcc.org/pe.
- Your doctor will increase your dose of acid reflux medicationsuch as omeprazole (Prilosec®), esomeprazole (Nexium®), and pantoprazole (Protonix®) for 3 months after your procedure. Tell your doctor if you need another prescription.
Rarely, people will develop a narrowing of the esophagus after the procedure, called a stricture. If you develop a stricture your doctor may need to perform a procedure called dilation at a later time, which will stretch the area open using a special balloon.
Call Your Doctor or Nurse If You Have:
- A temperature of 101° F (38.3° C) or higher
- Chest pain
- Painful or difficulty swallowing that is severe, getting worse, or lasts more than 5 days
- Weakness, faintness, or both
- Any other questions or concerns