Many people wonder what the treatment for Barrett's Esophagus (BE) is. Treatment for BE without dysplasia consists primarily of controlling esophageal acid exposure, usually with once a day proton pump inhibitor (PPI) medications like omeprazole (Prilosec®). Occasionally, twice a day dosing or even anti-reflux surgery may be necessary to completely control acid reflux. Unfortunately, suppressing acid does not usually cause the Barrett’s tissue to regress or even prevent it from progressing to cancer.
If dysplasia is found on any biopsies, treatment recommendations change:
- Low-grade dysplasia: Close surveillance with endoscopy every 6-12 months or ablation.
- High-grade dysplasia: Endoscopic therapy to destroy Barrett’s tissue or surgery.
- Early cancer: Endoscopic removal of focal cancer followed by tissue destruction or surgery
Experiments performed 20 years ago showed that in most people, once the Barrett’s tissue has been removed or destroyed, normal squamous tissue tends to regrow in the area as long as acid reflux is suppressed.
Endoscopic tissue destruction can be performed many ways: