What is High-Grade Dysplasia of the Esophagus?

High grade dysplasia (HGD) refers to precancerous changes in the cells of the esophagus. Gastroesophageal reflux disease (GERD) can be complicated by Barrett’s esophagus (BE), a change in the normal esophageal cells to intestinal-like cells. BE cells can become abnormal or dysplastic. Low grade and then high grade dysplasia can develop. HGD significantly increases a person’s risk for esophageal adenocarcinoma and in most cases will progress to cancer without any treatment. When someone is diagnosed with HGD, an intervention is advised including endoscopic resection and Barrx ablation or in some cases an esophagectomy is recommended for treatment.

Treatment of HGD requires an interdisciplinary approach that draws on various medical specialties. At BMC, physicians in our Center for Minimally Invasive Esophageal Therapies provide comprehensive, quality care including medical oncology, radiation oncology, thoracic surgery, gastroenterology, pathology, pulmonary medicine and radiology.

What are the Symptoms of High-Grade Dysplasia?

You may not experience any symptoms, but they can include:

  • A loss of your heartburn symptoms from GERD, can suggest Barrett’s esophagus has developed (although you can have heartburn and BE). HGD occurs in the setting of BE; thus, HGD would be found on an endoscopy for GERD or BE surveillance.
  • If you have trouble swallowing, this suggests the dyplasia has progressed to cancer.

What are the Causes?

Dysplasia is a complication of gastroesophageal disease (GERD) and BE.


How is High-Grade Dysplasia Diagnosed?

Diagnosis is often difficult, as symptoms may be limited.

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How is High-Grade Dysplasia Treated?

There are a variety of ways we can treat your high-grade dysplasia. Your physician will work with you and your family to decide the most appropriate course of action. Your options include:

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