At Memorial Sloan-Kettering, patients with Barrett's esophagus and/or gastroesophageal reflux disease (GERD) benefit from a comprehensive state-of-the-art program offering diagnostic, treatment, and surveillance programs for these conditions.
A variety of diagnostic tests are available to detect and monitor Barrett's esophagus and GERD. For example, some patients with Barrett's esophagus have cell abnormalities called dysplasia. Doctors recommend that people with Barrett's esophagus but no dysplasia have an endoscopy and biopsy performed every one to two years. Patients with mild dysplasia should have these tests every six months to one year, and possibly begin therapy to reduce acid reflux.
In patients with more severe dysplasia, surgery is recommended to remove the tissue affected by Barrett's esophagus, unless the patient's health makes him or her unable to withstand surgery. High-grade dysplasia indicates a high likelihood of developing esophageal cancer within a few years; some patients are found to already have early-stage adenocarcinoma after the tissue is removed and examined. When esophageal cancer is detected this early, the patient's outlook is usually favorable.
Memorial Sloan-Kettering also offers tests that assess esophageal function. One test evaluates how the muscles of the esophagus are working during swallowing, as a means of diagnosing problems with food movement through the esophagus. Another test determines whether or not stomach acids are present in the esophagus, as a way to detect GERD.
Treatment for Barrett's esophagus and GERD may include antireflux medications or surgery. Antireflux medications help alleviate the heartburn associated with these conditions, but do not stop the reflux of stomach contents. For patients who need to take these medications on a daily basis but who do not wish to do so (some are associated with unpleasant side effects, for example), surgery may be an option and an effective means of improving quality of life. Memorial Sloan-Kettering offers a minimally invasive surgical procedure that involves wrapping a portion of stomach tissue around the lower end of the esophagus to strengthen the gastroesophageal juncture and prevent digestive acids from bubbling up into the esophagus. Since this procedure is performed using laparoscopy, only small incisions are made in the abdomen, and the patient usually needs to stay in the hospital for just one night.
Some patients with Barrett's esophagus are also candidates for photodynamic therapy.
