Different post-treatment approaches after radiofrequency ablation may influence the recovery and recurrence of Barrett’s oesophagus, a new study claims.
Barrett’s oesophagus, a condition where the lining of the oesophagus changes due to long-term reflux, can increase the risk of oesophageal cancer.
Radiofrequency ablation (RFA) is a widely used treatment to remove damaged tissue, using heat energy to destroy abnormal cells in the oesophagus. Once these cells are removed, the body replaces them with a new, healthier lining called neosquamous epithelium (NSE).
A new study published in Scientific Reports examines how different follow-up treatments after RFA might affect the recovery of the oesophagus lining and the risk of Barrett’s returning.
The study
The study focused on two common follow-up care options: proton pump inhibitors (PPIs) and laparoscopic Nissen fundoplication (LNF). PPIs reduce stomach acid to minimise reflux damage, while LNF is a surgical procedure that strengthens the lower oesophageal sphincter to block reflux entirely.
Researchers used transmission electron microscopy (TEM) to examine the microstructure of NSE and its vulnerability to reflux damage. They identified differences between the two treatment groups:
- Healing differences: Patients on PPIs were more likely to have dilated intercellular spaces (DIS) – gaps between cells in the oesophagus lining – which may indicate ongoing reflux damage. In contrast, patients who underwent LNF had smaller intercellular spaces, suggesting better protection against reflux.
- Barrett’s recurrence: Over five years, recurrence occurred in 27 per cent of patients. Four of the five cases were in the PPI group, while only one occurred in the LNF group. Although the sample size was small and the difference was not statistically significant, the findings highlight potential differences in how these treatments protect the oesophagus.
What does this mean?
The study suggests that different post-RFA treatments may have varying effects on the healing and protection of the oesophagus.
While PPIs remain a widely used and effective option, LNF may offer additional benefits for some patients, particularly those with severe reflux or structural issues like hiatal hernias.
However, the small sample size means further research is needed to confirm these findings.
Whether through medication, surgery or lifestyle changes, protecting the oesophagus after RFA is essential for long-term success.
While the study highlights the importance of effective post-treatment care after RFA for Barrett’s oesophagus, ongoing monitoring of reflux can be a crucial step in protecting the newly formed oesophageal lining.
Peptest, a non-invasive test that detects pepsin in saliva, could help identify ongoing reflux, even in cases where symptoms are mild or absent.
Treating reflux without confirmation can mean months on medication that isn't the right fit. Peptest is a simple saliva test that detects pepsin — objective evidence of reflux — so you can act on what's actually happening.
- Results in 48 hours
- Saliva test, no invasive probe
- UK laboratory
Recent Comments