Patient education: Radiofrequency ablation for Barrett's esophagus (The Basics)

What is radiofrequency ablation for Barrett's esophagus? — 

Radiofrequency ablation, or "RFA," is a procedure that uses energy or heat to destroy tissue in the body. It can be used to treat Barrett's esophagus. This is a condition that affects the esophagus, which is the tube that carries food from the mouth to the stomach (figure 1).

In Barrett's esophagus, the normal cells in the lower part of the esophagus are replaced by a different type of cell. These cells can later turn into cancer of the esophagus, although the risk is low. RFA destroys these abnormal cells.

RFA is often done in a procedure area during an upper endoscopy (figure 2). During an endoscopy, the doctor uses an "endoscope," which is a thin tube with a camera on the end that lets them see inside the body. They use the endoscope to guide the ablation device into the esophagus to the area to be treated.

How do I prepare for RFA? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Before the procedure, your doctor will do an exam. They might do other tests or procedures to treat your Barrett's esophagus before doing RFA.

Your doctor will also ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes prescription and "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You might be asked to:

●Temporarily stop certain medicines before the procedure

You will be asked to:

●Avoid eating or drinking for some amount of time before the procedure

●Have someone else bring you home

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during RFA? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure you do not feel pain during the procedure. You might also get medicines to help you relax.

●The doctor will insert the endoscope into your esophagus. They will guide the ablation device to the area. The device heats up to destroy cells in the area.

●The doctor will remove the endoscope and any other tools.

What happens after RFA? — 

The staff will watch you closely as your anesthesia wears off. You can probably go home the same day.

As you recover:

●Take all your medicines as instructed, including medicines to help control acid. Your doctor or nurse will tell you when to restart any medicines you stopped.

●You might have pain in your chest area for a few days. You can take non-prescription medicines to relieve pain, such as acetaminophen (sample brand name: Tylenol). Or you might have gotten stronger prescription pain medicines to take for a short time. Follow all instructions for taking your pain medicines.

●When you are ready to eat, you will start with liquids. After a day or so, you can start to eat soft foods. You can start to eat your normal diet as you are able.

What are the risks of RFA? — 

Your doctor will talk to you about all the possible risks and answer your questions. Possible risks include:

●Chest pain

●Difficulty swallowing

●Bleeding

●Infection

●Narrowing of the esophagus

●A tear in the esophagus

●Injury to nearby nerves, organs, or other tissue

When should I call the doctor? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You vomit blood.

Call for advice if:

●You have signs of infection, like a fever of 100.4°F (38°C) or higher, or chills.

●You have pain in your throat, or feel like food gets stuck in your throat.

●You vomit something that looks like coffee grounds.

●You have blood in your bowel movements, or your bowel movements are black or tar colored.

●You have severe pain in your neck, chest, or back.

●You have very bad heartburn.

●You have wheezing, shortness of breath, or other breathing problems.

More on this topic

Patient education: Radiofrequency ablation (The Basics)
Patient education: Barrett's esophagus (The Basics)
Patient education: Upper endoscopy (The Basics)

Patient education: Barrett's esophagus (Beyond the Basics)
Patient education: Upper endoscopy (Beyond the Basics)