For Doctors & Healthcare Professionals

Barrett's oesophagus is a precancerous condition affecting the lining of the oesophagus, the muscular tube that carries food, liquids and saliva from the mouth to the stomach. Normally, the oesophagus is lined by a layer of short, squat cells called squamous cells. This lining is similar to skin in that it is multilayered and protects the underlying oesophagus from injury resulting from swallowed food and reflux of gastric contents. When chronic gastric reflux occurs and exposes the lining of the oesophagus to acid, this lining can be injured and break down.

What causes Barrett's oesophagus?

Barrett's oesophagus results from chronic exposure of the oesophagus to the gastric contents of the stomach caused by gastro-oesophageal reflux disease, commonly known as GORD. With prolonged acid exposure, normal cells can undergo a genetic change and transform into taller columnar cells. These Barrett's cells are vulnerable to further changes that can lead to cancer.

Who is at risk for developing Barrett's oesophagus?

Half of U.S. adults experience symptoms of GORD almost monthly while 20% experience symptoms weekly. 15 A result of prolonged GORD, Barrett's oesophagus occurs in as many as 13% of Caucasian men over the age of 50.

How many people have Barrett's oesophagus?

The incidence of Barrett's oesophagus is rising rapidly in the United States as well as other developed countries. Presently, Barrett's is estimated to affect about 3.3 million adults. 2-5 Each year 86,000 new cases are diagnosed. Men are at greatest risk and, although Barrett's oesophagus can be found at any age, the prevalence increases with advancing age until a plateau is reached in the 60s.

How is Barrett's oesophagus diagnosed?

A physician may evaluate a patient for Barrett's oesophagus if the patient has severe or prolonged GORD symptoms. Even if a patient's heartburn or GORD symptoms disappear, the patient could still have Barrett's oesophagus or worse, the condition could have progressed to more advanced stages of the disease. To diagnose Barrett's a physician performs an endoscopy, a procedure that allows inspection and tissue sampling of the oesophagus.

How is Barrett's oesophagus treated today?

Patients diagnosed with Barrett's oesophagus are treated for GORD symptoms and advised to return at scheduled intervals ranging from every three months to every three years for a repeat endoscopy and tissue inspection. This "watch and wait" approach is called surveillance. The objective of surveillance is to monitor for the progression of the disease.

Are more proactive treatment options available?

Yes. Ablation, which involves removing or destroying tissue inside the body, has been used to treat Barrett's oesophagus for more than 15 years. However, ablation therapy is not widely used to treat Barrett's due to limitations associated with existing technology. BÂRRX Medical, Inc. has developed a new tool for the treatment of Barrett's oesophagus that addresses the limitations of existing technology, making broad use of endoscopic ablation of the oesophagus practical. The BÂRRX Medical HALO 360 System provides uniform and controlled ablative therapy at a consistent depth, which can remove Barrett's cells and allow the regrowth of normal cells. It also provides preset sizing and fixed energy capabilities, making it possible for physicians to effectively treat patients without injuring healthy underlying tissue. The ability to provide a controlled amount of ablative therapy to diseased tissue significantly reduces the risk of complications normally associated with other forms of ablation therapy.

How does the HALO 360 System work?

Initially, a BÂRRX Medical HALO 360 sizing balloon is used to size the oesophagus. A correctly sized ablation catheter is then inflated within the area of the Barrett's. The HALO 360 energy generator is activated to deliver a rapid (less than one second) burst of ablative energy which removes a very thin (less than one millimeter) layer of the diseased oesophagus. This ablation (removal of tissue) is tightly controlled so as to avoid any injury to the normal, healthy underlying tissues. 18 New healthy tissue replaces the ablated Barrett's tissue in three to four weeks for most patients, according to trial results. The procedure is performed without incisions using conscious sedation in an out-patient setting. In clinical studies, the median procedure time was 26 minutes. Minor discomfort, which may be experienced by some patients, can be well-managed with medication. Following ablation therapy, patients resume acid suppression therapy.

What happens if Barrett's oesophagus goes untreated?

Untreated Barrett's oesophagus can result in the progression to high-grade dysplasia and development of a type of oesophageal cancer called adenocarcinoma.