Radiofrequency Ablation without Dysplasia?

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grega1117
New Member


Date Joined Jun 2014
Total Posts : 6
   Posted 6/9/2014 9:35 AM (GMT -6)   
Hi,

This question may have been answered elsewhere, but so far I've not been able to find it with a search of the site.

I was diagnosed with 6cm of Barrett's Esophagus (BE) in November of last year. There is no dysplasia, but I've been having trouble swallowing on and off ever since it all started. One of my doctors indicated it may be the result of esophageal spasms. Another indicated it is a result of the BE, while another said BE should not cause this symptom and that it may be neurological.

So I've been through several diagnostics including endoscopies, barium/modified barium swallow study (with speech language pathologist in attendance), neurological exams including electromyelography and nerve conductivity studies, and video fluoroscopy. Long story short, there are no esophageal strictures and there is no indication that the swallowing issues are the result of neurological problems and two of the doctors suggested whatever is causing the problem is not oropharyngeal in nature, but more likely lower esophagus.

Which leads me back to the BE. I think at this point that the erosive damage and metaplasia that has occurred over several years makes sense as the culprit for the swallowing issues. So now I'm trying to determine what to do about it. I've tried taking three different PPIs (Prilosec, Dexilant, and Prevacid), but within 3-4 days of starting each, I was experiencing severe stomach cramps and nausea. So I've switched over to H2RA drugs like famotidine (Pepcid), taken before bed to deal with nighttime reflux. I've also made significant dietary changes - e.g., dropping caffeine/soda/alcohol completely, switching to a paleo-style diet focused on fruits, veggies, eggs, fish, and other whole foods (nothing processed), supplementation with omega and krill oils, colostrum, glutamine, and spirulina...etc...

I've lost over 50 pounds since this all started last year and am planning to lose another 50 to put me around my "ideal" weight of 200. I've not had any reflux to speak of in the months since starting on my new diet, but still the swallowing issue is with me - not as intense as before, but still there. So while it feels like things are on the right track, I really need to find a way to get past this one issue and I believe it is tied to the BE.

Apologies for the long story and I'll get to my question: is there any way to get radiofrequency ablation done when the patient does not have dysplasia? I'm wondering if eradicating the BE would be the best thing at this point. If in fact the swallowing issues are resulting from erosion or esophageal spasming, wouldn't it make sense to ablate and remove the offending tissue? I see reports indicating that ablation can help even in non-dysplastic BE:

http://www.medicalnewstoday.com/releases/62369.php
http://gastro.oxfordjournals.org/content/early/2013/03/26/gastro.got009.full

Granted, there are some potential conflicts of interest in these articles, but I'm just trying to get to the bottom of this problem and if ablation may be able to help, I'm hoping to find a doctor who will do this even in the absence of dysplasia. I realize that insurance may not cover it, but if there's a chance it can stop this problem in its tracks, I'm willing to take on the financial burden. This swallowing issue hit me pretty hard and while I'm starting, slowly but surely, to recover a bit at a time, I'm still concerned about having a pre-cancerous segment in my esophagus...especially if there's a treatment out there that can knock it out.

Thanks for reading - any information is greatly appreciated.

Greg
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