Eradication of Barrett's epithelium does not alter esophageal motility, lower esophageal sphincter function, or mural characteristics

B. R. Stotland, D. C. Metz, Douglas Orrick Faigel, W. B. Long, D. B. Smith, R. P. Obelmejias, M. L. Kochman, E. E. Furth, G. G. Ginsberg

Research output: Contribution to journalArticle

Abstract

Ablation of Barrett's epithelium (BE) in an anacidic environment facilitates squamous reepithelialization. The impact of thermal therapy on esophageal motility, lower esophageal sphincter function and the esophageal wall is unknown. Aims: To determine the effects, if any, of thermal ablation of BE on esophageal function and mural characteristics as assessed by endosonography (EUS). Methods: Three patients with BE, 2-5 cm, without dysplasia, underwent gastric analysis and 24 hr pHmetry in the presence of high dose antisecretory therapy (to confirm adequate control of esophageal acid exposure), esophageal manometry, EUS, and biopsies before and after laser photoablation (Nd:YAG or KTP), supplemented with multipolar electrocautery, at 4 week intervals as needed until reepithelialization was complete. Results: Gastric acid output and distal esophageal acid exposure were controlled in all patients throughout the therapy (2 with omeprazole 20 mg BID, 1 with 40 mg BID). The BE lengths were 2, 3, & 5 cm. The number of sessions to achieve eradication (confirmed by endoscopy and biopsy) were 1, 3, & 4 respectively. Measurements of lower esophageal sphincter pressure, distal esophageal contraction amplitude, duration and velocity and percentage of ineffective or non-peristaltic contractions did not change significantly after therapy. EUS demonstrated no change in mural thickness nor disruption of the wall layer pattern. Conclusions: Thermal ablation of short-segments of BE does not appear to cause deterioration or improvement of esophageal function nor alter mural characteristics.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume45
Issue number4
StatePublished - 1997
Externally publishedYes

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Lower Esophageal Sphincter
Barrett Esophagus
Hot Temperature
Biopsy
Endosonography
Electrocoagulation
Acids
Omeprazole
Gastric Acid
Solid-State Lasers
Manometry
Therapeutics
Endoscopy
Stomach
Pressure

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Eradication of Barrett's epithelium does not alter esophageal motility, lower esophageal sphincter function, or mural characteristics. / Stotland, B. R.; Metz, D. C.; Faigel, Douglas Orrick; Long, W. B.; Smith, D. B.; Obelmejias, R. P.; Kochman, M. L.; Furth, E. E.; Ginsberg, G. G.

In: Gastrointestinal Endoscopy, Vol. 45, No. 4, 1997.

Research output: Contribution to journalArticle

Stotland, BR, Metz, DC, Faigel, DO, Long, WB, Smith, DB, Obelmejias, RP, Kochman, ML, Furth, EE & Ginsberg, GG 1997, 'Eradication of Barrett's epithelium does not alter esophageal motility, lower esophageal sphincter function, or mural characteristics', Gastrointestinal Endoscopy, vol. 45, no. 4.
Stotland, B. R. ; Metz, D. C. ; Faigel, Douglas Orrick ; Long, W. B. ; Smith, D. B. ; Obelmejias, R. P. ; Kochman, M. L. ; Furth, E. E. ; Ginsberg, G. G. / Eradication of Barrett's epithelium does not alter esophageal motility, lower esophageal sphincter function, or mural characteristics. In: Gastrointestinal Endoscopy. 1997 ; Vol. 45, No. 4.
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AU - Stotland, B. R.

AU - Metz, D. C.

AU - Faigel, Douglas Orrick

AU - Long, W. B.

AU - Smith, D. B.

AU - Obelmejias, R. P.

AU - Kochman, M. L.

AU - Furth, E. E.

AU - Ginsberg, G. G.

PY - 1997

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N2 - Ablation of Barrett's epithelium (BE) in an anacidic environment facilitates squamous reepithelialization. The impact of thermal therapy on esophageal motility, lower esophageal sphincter function and the esophageal wall is unknown. Aims: To determine the effects, if any, of thermal ablation of BE on esophageal function and mural characteristics as assessed by endosonography (EUS). Methods: Three patients with BE, 2-5 cm, without dysplasia, underwent gastric analysis and 24 hr pHmetry in the presence of high dose antisecretory therapy (to confirm adequate control of esophageal acid exposure), esophageal manometry, EUS, and biopsies before and after laser photoablation (Nd:YAG or KTP), supplemented with multipolar electrocautery, at 4 week intervals as needed until reepithelialization was complete. Results: Gastric acid output and distal esophageal acid exposure were controlled in all patients throughout the therapy (2 with omeprazole 20 mg BID, 1 with 40 mg BID). The BE lengths were 2, 3, & 5 cm. The number of sessions to achieve eradication (confirmed by endoscopy and biopsy) were 1, 3, & 4 respectively. Measurements of lower esophageal sphincter pressure, distal esophageal contraction amplitude, duration and velocity and percentage of ineffective or non-peristaltic contractions did not change significantly after therapy. EUS demonstrated no change in mural thickness nor disruption of the wall layer pattern. Conclusions: Thermal ablation of short-segments of BE does not appear to cause deterioration or improvement of esophageal function nor alter mural characteristics.

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