TREATMENT OF GERD

Treatment should improve symptoms, and may keep Barrett's esophagus from getting worse.

Lifestyle changes include:

• Avoid dietary fat, chocolate, caffeine, and peppermint because they may cause lower esophageal pressure and allow stomach acid to flow backwards
• Avoid alcohol and tobacco
• Avoid lying down after meals
• Lose weight
• Sleep with the head of the bed elevated
• Take all medications with plenty of water

Medications to relieve symptoms and control gastroesophageal reflux include:

• Proton pump inhibitors
• Antacids after meals and at bedtime
• Histamine H2 receptor blockers
• Promotility agents

Anti-reflux surgery may help with symptoms of GERD, but will not cause Barrett's esophagus to go away.

TREATMENT OF BARRETT'S ESOPHAGUS

Surgery or other procedures may be recommended if a biopsy shows cell changes that are very likely to lead to cancer. Such changes are called severe or high-grade dysplasia.

Some of these procedures remove the harmful tissue in your esophagus, where the cancer is most likely to develop.

• Photodynamic therapy (PDT) involves the use of a special laser device, called an esophageal balloon, along with a drug called Photofrin.
• Other procedures use different types of high energy to destroy the precancerous tissue.
• Surgery to remove the abnormal lining

People with Barrett's esophagus have an increased risk of esophageal cancer. Still, only a small number of people with Barrett's esophagus develop cancer. Follow-up endoscopy to look for dysplasia or cancer is often advised.

Treatment should improve symptoms and may keep Barrett's esophagus from getting worse. None of these treatments will reverse the changes that may lead to cancer.

Call your health care provider if:

• Heartburn lasts for longer than a few days, or you have pain or difficulty swallowing.
• You have been diagnosed with Barrett's esophagus and your symptoms get worse, or new symptoms (weight loss, problems swallowing) develop.