Treatment for Barrett's oesophagus

Abstract

Despite their failure to eradicate Barrett's oesophagus, the role of medical and surgical interventions to reduce the troubling symptoms and sequelae of GORD is not questioned. Whether therapies for GORD reduce the cancer risk is not yet known. Ablative therapies have an increasing role in the management of dysplasia within Barrett's and current data would favour the use of radiofrequency ablation compared with photodynamic therapy. Radiofrequency ablation has been shown to yield significantly fewer complications than photodynamic therapy and is very efficacious at eradicating both dysplasia and Barrett's itself. However, long-term follow-up data are still needed before radiofrequency ablation can be used in routine clinical care without the need for very careful post-treatment surveillance. More clinical trial data and in particular randomised controlled trials are required to assess whether or not the cancer risk is reduced in routine clinical practice.

Economic evaluation of endoscopic radiofrequency ablation for the treatment of dysplastic Barrett’s esophagus in Spain

“…There is a general agreement with regard to the efficiency of RFA for the management of HGD patients (5,10,25). In this base-case analysis, RFA-EMR was better than SoC alone in these patients.…”

“…Once established, BE does not regress despite the control of gastroesophageal reflux disease symptoms (4) and is considered to be a precancerous condition. The evolutionary stages of the disease may provide an opportunity to intervene prior to the development of EAC (5).…”

Treatment for non-dysplastic Barrett’s oesophagus: a well-informed, demanding patient

“…Every treatment should reduce this risk without affecting on your life style, for instance causing a problem of strictures, due to an imperfect healing.'' ''Drugs and anti-reflux surgery: it seems that there is not a clear benchmarking of these treatments [6]'' Roger said.…”

“…''Both therapies are useful in symptom control [6], anyway. Proton pump inhibitors at a dose required to control symptoms are recommended in patients with reflux oesophagitis or Barrett's oesophagus [7].…”

“…The results will be fully transferable to your case. 1 As for now, we know that medical therapies have little clinical effect on reversing Barrett's oesophagus [6] and there has been concern about the possible role of hypergastrinemia [9], a consequence of acid suppression, in favouring Barrett's progression or carcinoma development.'' ''A surgical approach would be attractive if it is definitive, meaning that your risk of malignant transformation becomes near to nil.…”