Barretts Esophagus

Barrett's esophagus monitoring

Although rare, Barrett’s esophagus may eventually become esophageal cancer in some people. You may be able to detect changes early, by working with experts to monitor the condition.

City of Hope offers one of only a few programs in the country dedicated to Barrett’s esophagus. Our team has extensive experience and training to detect changes early and provide treatment designed to prevent cancer.

Cancer Treatment Centers of America® (CTCA) is now City of Hope®, joining forces to expand patient access to personalized, comprehensive cancer care.

Barrett's esophagus monitoring

If you’ve been diagnosed with Barrett’s esophagus, regular monitoring of the condition helps detect any cellular changes as early as possible. Your team at City of Hope will develop a personalized testing and monitoring plan with a schedule based on your needs, risk factors and diagnosis.

We will use state-of-the-art techniques to sample esophageal tissue at regular intervals. Ongoing testing will help us identify changes in esophageal tissue when they happen and adjust the plan if needed.

Our evidence-based methods are designed to detect cancer as early as possible. Only a small percentage of people with Barrett’s esophagus develop esophageal cancer. But if the condition becomes malignant (cancerous), catching it early may make the disease easier to treat and improve your results.

Barrett's surveillance schedule

Your City of Hope gastroenterologist will recommend a surveillance schedule based on the stage of Barrett’s esophagus. In general, our monitoring recommendations may include:

No dysplasia (healthy, unchanged cells)
  —Perform endoscopy every one to three years, depending on the length of the Barrett’s segment

Low-grade dysplasia (abnormal cell changes)
  —Confirm diagnosis and repeat endoscopy in six months

Intermediate dysplasia
  —Perform an endoscopic eradication procedure (endoscopic mucosal resection, radiofrequency ablation or cryotherapy), followed by repeat endoscopy in six months

High-grade dysplasia
  —Perform endoscopic eradication, followed by a repeat procedure in three months and possibly surgery if the condition is persistent

Upper endoscopy and biopsy

The test to monitor Barrett's esophagus involves upper endoscopy and biopsy. The City of Hope team will:

  1. Fully sedate you so that you are comfortable and don’t remember the procedure
  2. Gently guide an endoscope (tool with a tiny light and camera) down your throat and into your esophagus
  3. Use the endoscope to examine Barrett’s tissue throughout the esophagus, looking for anything that may have changed
  4. Take a small tissue sample from the esophageal lining
  5. Take additional samples of tissue every 2 cm/0.75 inch and any other tissue that appears abnormal
  6. Have the tissue samples examined under a microscope by one of our expert pathologists, who have extensive experience detecting cancerous changes in cells

The procedure takes less than an hour. You may have to wait another half-hour to an hour for sedation to wear off before you can go home. You always need a caregiver to take you home after the procedure. The procedure is safe and has few side effects, except perhaps a mildly sore throat that may last a day or so.

WATS3D technique for Barrett's esophagus

A traditional biopsy technique, taking samples every couple of centimeters, may miss areas with abnormal cells in between. City of Hope now uses a state-of-the-art system to sample a wider area of the esophagus. It’s called WATS3D (wide-area transepithelial sampling in three dimensions).

This evidence-based technique uses artificial intelligence to detect cells suggestive of precancerous cells that could be missed with the traditional method. It may also detect abnormal cells missed by the biopsy.

While conducting your upper endoscopy, the City of Hope team will use the WATS3D system’s technique, following this procedure:

  1. Inserting a special small brush into the esophagus through the endoscope
  2. Rubbing it against abnormal Barrett’s esophagus, capturing cells over a wider area, up to 5 cm/2 inches
  3. Using additional brushes for additional areas
  4. Sending the brushes to a special laboratory, which analyzes the cells

The WATS3D lab will then compare your cells to a national database of esophageal cancer cells. This artificial intelligence technique helps the team assess whether cells are abnormal.

Biopsy and WATS3D results are usually available in a few days. If Barrett’s esophagus is worsening or progressing to precancerous cells (dysplasia), we’ll offer treatment options based on your individual needs.

Care for the whole person during Barrett’s esophagus monitoring

Make an appointment with our Barrett's esophagus team

If you have GERD or other gastrointestinal symptoms, we're ready to help you. To learn more about our Barrett's esophagus care or to make an appointment, call or chat online with a member of our team.