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Denise
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Joined: 03 Apr 2018
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Quote Denise Replybullet Topic: Ablation Therapy
    Posted: 05 Apr 2018 at 1:45pm
Hi
I have recently been diagnosed with Barrett's oesophagus with high grade dysplasia and also two cancerous nodules 7mm and 4mm. I am due surgery next week to remove these.

Has anyone had to ablation therapy to "burn off" the Barrett's? I would like to ask for this procedures but not sure what it entails.

I am also terrified of the gastroscopy procedure, even with sedation and have opted for a general anaesthetic. As I will need regular (6 monthly) checks, has anyone successfully been able to have a general anaesthetic for check ups?

I feel a "bit in the dark" and still accepting the diagnosis.
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chrisrob
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Quote chrisrob Replybullet Posted: 05 Apr 2018 at 2:26pm
Hi Denise and welcome to the forum.

Sorry to hear of your diagnosis but glad it has been found in time to act.

Assuming your HGD has been confirmed, you should be offered RFA treatment (Radio Frequecncy Ablation, sometimes referred to as "HALO").

There are a few people on this forum who have had the treatment and you may read a patient's experience on the Barrett's Wessex website, here.
You may also read Jeff's, Bill's and Andrew's stories linked to at the bottom of the Members' Stories page.

This treatment is available at many hospitals in UK.
You may find a list linked to from this page of the Barrett's Oesophagus UK website, though the list may be a little out of date.

Barrett's Wessex purchased an RFA machine for Southampton General Hospital in 2012 where it continues to save lives. The newly established Barrett's Wales group is currently campaigning to get the Welsh Assembly to make this available in Wales. (Currently Welsh patients requiring the treatment have to be sent to Gloucester or Liverpool.)

Surveillance, check-up, scopes are not nice but most cope with sedation. (For me sedation doesn't work and I just have the throat spray - but it only takes a few minutes.) They don't like to give anaesthetic for the procedure as it carries its own risks - and requires the presence of an anaesthetist.

All the best and hope you get the treatment soon.

Chris
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GrahamB
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Quote GrahamB Replybullet Posted: 11 Apr 2018 at 1:42pm
Denise

I am currently going through a series of Radio Frequency Ablation procedures to treat my Barrett's. In my case I had extensive low grade dysplasia rather than high grade but started with a pretty long segment (C8M8).

When you have RFA (at least in my case) you get a much deeper level of sedation than for a standard gastroscopy (we use a thing called Proforol). As well as my specialist there is an an aneasthetist present and I go all the way under for the duration.

Post procedure isn't too bad. Pain meds take away most of the post op discomfort and the modified diet for a week or so is fairly easy to handle.

There are some potential post procedure complications (which your sepcialist will talk you through). The most common is a stricture where the localised trauma of ablation causes a tightening in the oesophagus. It is not that common but I have had one stricture which was easily sorted through dilation (though it involves another gastroscopy).

The big upside with RFA is that it is the one thing that can actually remove Barrett's. My C8M8 was down to C2M4 before my last procedure and (hoepfully) will have been removed altogether after another run or two. After the ablation has done its job the next step is to tackle the potential cause for the reflux. I have a 4cm sliding Hiatus Hernia so will probably be going down the fundoplication route.

Try not to stress too much over the endoscopies, they get easier to handle the more you have! I always have sedation - mainly becuase I discussed the options with my specialist and she said having me sedated made her life easier! - and generally sleep through the whole thing.

From what I understand general anaethesia isn't practical for endoscopic procedures as a "general" requries the medical team to take control of your breathing which makes getting the endoscope in impossible.

Best of luck.

G
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