In patients with gastroesophageal reflux disease (GERD), stomach acid and enzymes can injure the esophageal lining. Over time, this damage can cause inflammation and genetic changes to esophageal cells, causing them to become intestinal tissue. This disorder is called “intestinal metaplasia” or Barrett’s esophagus. Patients who develop this disease have an increased risk for developing cancer of the esophagus.
The HALO radiofrequency ablation system is an incisionless endoscopic treatment option for Barrett’s esophagus. The system works by creating controlled heating and removal of tissue using radio frequency energy. The HALO ablation procedure specifically targets only the layer of diseased tissue without harming the healthy structures underneath it. Combined with treatments to control acid production, this technique allows normal esophageal tissue to replace the intestinal metaplasia.
How do I prepare for the procedure?
If you take any medications to prevent the formation of a blood clot, you should notify your physician as, with the exception of aspirin, these are often held for a number of days prior to and after the procedure. You should not eat or drink after midnight before the procedure (though if necessary, you may have small sips of water in the morning). Your doctor will tell you if you need to take your morning medications. When you arrive for the procedure, you will change into a gown, sign a consent form and receive intravenous sedation. As you receive sedation for the procedure, you will need to have someone available to drive you home.
How is the procedure performed?
While you are sedated, a device is inserted through the mouth into the esophagus and used to deliver a controlled level of energy to remove a thin layer of diseased tissue. Less than one second of energy removes tissue to a depth of about one millimeter. The ability to provide a controlled amount of heat to diseased tissue is one mechanism by which this therapy has a lower rate of complications than other forms of ablation therapy.
What should I expect after the procedure?
Some pain is common, particularly after the first ablation as the first treatment requires treating the largest amount of tissue. Your doctor will send you home with a prescription for pain medication and place you on a special diet for, in most cases, a few days. You will be continued on medication to suppress production of stomach acid. In six to eight weeks, the procedure will be repeated until all of the tissue is successfully ablated.
What are the risks?
The HALO radiofrequency ablation procedure is considered very safe. Patients may experience minor side effects, such as chest discomfort and difficulty swallowing for several days after the procedure. As with any medical procedure, there are risks of more significant complication. Possible complications include anesthesia reactions, mucosal laceration, infection, narrowing of the esophagus and bleeding. Should you have any unexpected trouble after the procedure, please call us immediately.
What are the treatment benefits?
After treatment, 98 percent of people are free of Barrett’s esophagus 30 months after two or three RFA treatments. Studies show that when the Barrett’s tissue is removed, it is typically replaced by normal, healthy tissue within three to four weeks. Recent five-year follow-up of longer trials shows that the effects of radiofrequency ablation are durable.