SJPHS gastroenterologists (GI) and the GI fellowship program, one of the largest community teaching programs in Michigan for gastroenterology, are taking the lead in the treatment of esophageal diseases. Gastroesophageal reflux (GERD) has steadily grown in prevalence in the US. Presently, one-third of the population suffers from reflux symptoms at least once per month. Ten percent suffer from significant reflux symptoms up to three or more times per week.

 

With repetitive exposure to stomach acid, the lining of the esophagus undergoes changes and begins to resemble the lining of the stomach, a condition referred to as Barrett’s esophagus. Patients with Barrett’s esophagus are at an increased risk of developing esophageal cancer.

 

Barrett’s esophagus can progress to a condition known as low-grade dysplasia, then to high-grade dysplasia, resulting in esophageal cancer. Depending on whether the patient has low- or high-grade dysplasia, a close surveillance program has to be instituted in which upper endoscopy must be performed every three to six months.

 

In the past, patients with high-grade dysplasia would require esophagectomy, the removal of the esophagus. Presently, the Providence Hospital Endoscopy Unit can treat these patients and reverse the Barrett’s esophagus to normal using a new therapy called the BÂRRX Halo procedure.

 

This outpatient procedure changes the progression of low-grade dysplasia to high-grade dysplasia and cancer by destroying the superficial lining of the esophagus, which then regenerates and grows back as normal tissue. It involves a circumferential balloon, which sends radiofrequency energy that ablates and destroys the superficial lining of the esophagus. After two to four treatments the esophageal lining returns to normal, eliminating the Barrett’s esophagus.

 

Patients at risk for Barrett’s esophagus are those who have had GERD symptoms for 10 years or longer, are overweight, smoke, and regularly use alcohol or eat foods high in fat.