The Center for Minimally Invasive Esophageal Therapies at Boston Medical Center provides you and your family with unmatched patient care using the most advanced and effective medical treatment in New England. Our dedicated team collaborates to treat conditions such as Barrett's esophagus in our state-of-the-art facilities. We perform innovative procedures such as mucosal ablation, and help guide you on the path to recovery in the most comfortable way possible.
Barrett's esophagus is a condition characterized by chronic acid reflex that continually irritates the esophagus and can cause precancerous cells to grow. When the lower esophageal sphincter (the flap of skin that keeps stomach contents away from the esophagus) does not stay closed, the backflow that touches the esophagus creates a burning sensation and can lead to cell changes. The usually smooth lining of the esophagus can become rougher and paler in color, which may lead to esophageal cancer.
Your physician will discuss management techniques with you, which include watchful waiting and various treatment methods. One such treatment option is mucosal ablation. For this procedure, a physician applies heat energy to the mucosal lining of your esophagus to destroy precancerous cells. The goal is to encourage healthy cells to replace them. If you are found to have severe damage or cell changes in different parts of the esophagus, we may recommend surgical removal of part or all instead—esophagectomy.
How to Prepare
Before mucosal ablation, you will have a physical examination and medical history, and your physician may order one or more of the following tests:
- Blood test
- Biopsy, where a tissue sample is removed for analysis
- Computed Tomography (CT ) scan
- Magnetic Resonance Imaging (MRI)
Doctors order CT, or computed tomography, scans when they want to see a two-dimensional image of your body, including a view of the lymph nodes. If contrast dye is used to improve the computer image, you may need to avoid eating or drinking for four to six hours before the test. Be sure to tell your provider before the test if you have any allergies or if you have kidney problems.
You should provide a list of all prescription and over-the-counter medications, herbs and supplements, and any allergies. You will most likely be asked to avoid food and drink after midnight on the night before your scheduled procedure. Water is usually allowed up to two hours beforehand, however.
What to Expect
Mucosal ablation may be performed on an outpatient basis; that is, you may not have to stay overnight. You may not need general anesthesia—a mild sedative and local anesthetic are often sufficient. You can resume normal activities within one week, as opposed to open surgery, which requires hospital stays, longer recovery, and more risk of infection and complications.
Generally, an intravenous (IV) line is inserted in your hand or arm followed by a pain-killing solution and a narrow probe with catheter into your throat. Once the probe is placed on the mucosal lining of the esophagus, the ablation energy, which is warm, is applied. The heat also helps close small blood vessels and lessens the risk of bleeding. After the abnormal cells are killed, they shrink and turn to scar tissue over time.
After your procedure, you may have a CT or MR images to make sure the treatment was successful in destroying abnormal tissue. If not, the ablation procedure may be repeated.
You should plan for a ride home, and to limit driving, strenuous activity, and making important decisions for the first day or two following the procedure, as painkillers can affect decision-making. Otherwise, you should be able to resume normal activities within the week.
Minor complications may include:
- Low-grade fever
Call us if you notice these symptoms or anything else that concerns you, or if you have trouble breathing.