An endoscopy is a procedure that uses an endoscope, or a tube with a small camera and light on it. An endoscope allows your doctor to see the inside of your esophagus. Your doctor will be checking to make sure that your esophagus looks pink and shiny. Your doctor may also take a tissue sample that will allow them to understand what changes are going on in your esophagus. Your doctor will examine the tissue sample for dysplasia, or the development of abnormal cells.
The tissue sample be ranked based on the following degrees of change:. Options may include:. If you have no or low-grade dysplasia, your doctor will likely recommend treatments that will help you manage your GERD symptoms.
You may also be a candidate for surgeries that can help you manage your GERD symptoms. There are two surgeries that are commonly performed on people with GERD, which include:. This surgery attempts to strengthen the lower esophageal sphincter LES by wrapping the top of your stomach around the outside of the LES.
In this procedure, your doctor will insert the LINX device around lower esophagus. The LINX device is made up of tiny metal beads that use magnetic attraction to keep the contents of your stomach from leaking into your esophagus. A doctor performs the Stretta procedure with an endoscope.
Radio waves are used to cause changes in the muscles of the esophagus near where it joins the stomach. The technique strengthens the muscles and decreases reflux of the stomach contents. Your doctor may recommend more invasive procedures if you have high-grade dysplasia. For example, removing damaged areas of the esophagus through the use of endoscopy.
In some cases, entire portions of the esophagus are removed. Other treatments include:. This procedure uses an endoscope with a special attachment that emits heat. The heat kills abnormal cells.
In this procedure, an endoscope dispenses cold gas or liquid that freeze the abnormal cells. The cells are allowed to thaw, and then are frozen again. Treatment includes:. Dietary and lifestyle changes are the first steps in treating Barrett's esophagus. Certain foods make the reflux worse.
Suggestions to help alleviate symptoms include:. If lifestyle and dietary changes do not work, medications may be prescribed.
There are two categories of medicines for reflux. One decreases the level of acid in your stomach, and one increases the level of motility movement in the upper gastrointestinal tract. Over-the-counter antacids are best for intermittent and relatively infrequent symptoms of reflux. When taken frequently, antacids may worsen the problem. They leave the stomach quickly, and your stomach actually increases acid production as a result.
Histamine 2 H2 blockers are drugs that help lower acid secretion. H2 blockers heal esophageal erosions in about 50 percent of patients. Proton pump inhibitors PPIs are drugs that block the three major pathways for acid production. PPIs suppress acid production much more effectively than H2 blockers. PPIs are the most effective medication for healing erosive esophagitis and providing long-term control of GERD symptoms.
Prokinetic agents are drugs that enhance the activity of the smooth muscle of your gastrointestinal tract. Doctors call this approach surveillance. Talk with your doctor about what level of surveillance is best for you. Your doctor may recommend endoscopies more frequently if you have high-grade dysplasia rather than low-grade or no dysplasia. These medicines can prevent further damage to your esophagus and, in some cases, heal existing damage. All of these medicines are available by prescription.
Omeprazole and lansoprazole are also available in over-the-counter strength. Endoscopic ablative therapies use different techniques to destroy the dysplasia in your esophagus. After the therapies, your body should begin making normal esophageal cells.
A doctor, usually a gastroenterologist or surgeon, performs these procedures at certain hospitals and outpatient centers. You will receive local anesthesia and a sedative. The most common procedures are the following:. The doctor then removes the tissue with an endoscope.
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