About Your Barrx Ablation

This information will help you prepare for your BarrxTM ablation procedure at Memorial Sloan Kettering (MSK).

Barrx ablation is a procedure used to treat Barrett’s esophagus. Barrett’s esophagus is a condition that can result from having chronic heartburn or gastroesophageal reflux disease (GERD). In Barrett’s esophagus, tissue similar to the lining of your intestines replaces the tissue lining your esophagus.

You will have your Barrx ablation during an upper endoscopy procedure. For the upper endoscopy, your doctor will use a flexible tube called an endoscope to see the inside of your esophagus (food pipe), on a video monitor. Barrx ablation uses radiofrequency energy (heat) to destroy the abnormal cells. 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 medication 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. If you don’t have someone to do this, call one of the agencies below. They will send someone to go home with you. There’s usually a charge for this service, and you will need to provide transportation.

Agencies in New York                                         Agencies in New Jersey
Partners in Care: 888-735-8913                                         Caring People: 877-227-4649
Caring People: 877-227-4649                                          

 

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The Day Before Your Procedure

Stop taking certain medications

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Advil®, Motrin®), and naproxen (e.g., Aleve®). These medications can cause bleeding. For more information, ask your nurse for the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs) or search for it on mskcc.org/pe

Note the time of your appointment

A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. They 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.

Instructions for eating and drinking before your procedure

12 ounces of water
  • Do not eat anything after midnight the night before your procedure. This includes hard candy and gum.
  • Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of water (see figure).
  • Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This includes water.
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The Day of Your Procedure

Things to remember

  • Take the medications you were instructed to take the morning of your procedure with a few sips of water.
  • Don’t 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

MSK’s parking garage is located on East 66th Street between York and First Avenues. To reach the garage, turn onto 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 you can walk through that connects the garage to the hospital. If you have questions about prices, call 212-639-2338.

There are also other parking garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and 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, between East 67th and East 68th Streets. 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. People 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. They 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 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.

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After Your Procedure

In the hospital

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 or difficulty swallowing, and nausea or vomiting. Your nurse will help you manage these symptoms.

You may need to change your dose of acid reflux medication, such as omeprazole (Prilosec®), esomeprazole (Nexium®), and pantoprazole (Protonix®). Your doctor will discuss this with you.

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.

At home

After your Barrx ablation, you may have a sore throat, chest discomfort, difficulty or pain with swallowing, nausea, 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. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

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.

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