I was diagnosed with Barrett’s Esophagus Stage 0 after one endoscopy procedures /biopsy about 1.5 years ago. I was told I should have another biopsy every 3 years. However, I have also heard that one must have 2 biopsies of Stage 0 results within 3 months of each other to confirm the stage of the diagnosis. Can you please clarify?
Thank you for your question. Barrett’s Esophagus is an advanced stage of GERD and must be monitored closely. If you haven’t yet done so, please read our article titled If you’ve been diagnosed with Barrett’s Esophagus. Now let’s answer your question.
Barrett’s esophagus is not staged in a way resembling your description. Barrett’s is diagnosed when a biopsy shows a particular type of cell in a visible area of abnormal tissue in the lower esophagus. Barrett’s esophagus is described in terms of length where less than 3 visible cm’s is termed “short segment” and greater than 3 cm is “long segment.”
Another relatively involved classification that has been looked at is called the Prague C and M. This measures the circumference of the abnormal tissue and the maximum upward extent. This is complex and I am sure this is not what is being described to you. Lastly, Barrett’s esophagus can progress toward cancer by passing through two additional stages: low-grade dysplasia and high-grade dysplasia. The vast majority of Barrett’s does not involve dysplasia and is sometimes termed non-dysplastic Barrett’s.
It only takes one biopsy that shows the special cells described above to make the diagnosis, and if those cells are ever seen in visible abnormal tissues, serial endoscopies are needed, usually every 3 years.
RF Ablation treatment for Barrett’s esophagus
Approximately 10–15% of patients with GERD have Barrett’s Esophagus, which increases the risk of developing esophageal cancer. Observation, which is your current treatment methodology, is the most common approach. However, a promising treatment has emerged called Radiofrequency Ablation (RFA). With this therapy, the Barrett’s tissue is eliminated using radio-frequency energy. When this is complete, the cells in the esophagus regenerate. In recent years, there has been some controversy over when to apply this technology. Several studies and guidelines suggest that this ablation procedure be utilized only when the non-dysplastic Barrett’s has progressed to dysplasia.
There has been extensive research on RFA, yet we can not say definitively say at this point that RFA does stop the progression of the disease and stops cancer from developing, but results are very promising. Cancers have developed within previously ablated tissues, but this is very uncommon. However, it appears that the development of cancer after ablation is indeed, less likely. I stress that an experienced GERD physician skilled with RFA should perform this procedure and that a follow-up schedule be strictly adhered to with endoscopy procedures to determine if re-treatment is necessary. For additional information, please review our article: RF Ablation for Barrett’s Esophagus.
Why you need to take your symptoms seriously
Finally, I would like to add that everyone should take their symptoms seriously since the progression to Barrett’s Esophagus and esophageal cancer is certainly on the increase today. ABC Tampa delivered an excellent segment on GERD that drives home the importance of taking your symptoms seriously. Please take a few minutes and watch this excellent video by news anchor Wendy Ryan. If you have not yet learned about the progression of GERD, I also highly recommend you read our article The Progressive Stages of GERD.