HALO Ablation Technology: Treating Barrett’s Esophagus

Bon Secours Harbour View Endoscopy Center, HALO Ablation, Barrett's Esophagus treatment Hampton Roads, cancer careFor those of you who have never heard of it, Barrett’s esophagus is a precancerous condition of the lining of the esophagus caused by gastroesophageal reflux disease (GERD). Left untreated, backward flow of stomach contents such as acid and bile into the esophagus can lead to injury and chronic inflammation of the esophagus lining. 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.

A proportion of GERD patients are thus at risk of developing Barrett’s esophagus, which can lead to esophageal adenocarcinoma, a lethal cancer with a five-year survival rate of approximately 15%. Approximately 44% of U.S. adults experience symptoms of GERD almost monthly while 18% experience symptoms weekly.  A result of prolonged GERD, Barrett’s esophagus occurs in approximately 13% of Caucasian men over the age of 50.

How is Barrett’s esophagus diagnosed?
A physician may evaluate a patient for Barrett’s esophagus if the patient has severe or prolonged GERD symptoms. Even if a patient’s heartburn or GERD symptoms disappear, the patient could still have Barrett’s esophagus 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 esophagus.

How is Barrett’s esophagus treated today?
Patients diagnosed with Barrett’s esophagus are treated for GERD 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 the progression of the disease. However, surveillance can be burdensome for the patient in many ways. First, an endoscopy requires a visit to the hospital, anesthesia and multiple tissue samples (biopsies) extracted from the patient’s esophagus. Patients typically need a few days to recover. This recovery period usually includes a modified diet of liquid or soft foods.

What is HALO ablation technology?

The HALO ablation technology is a very specific type of ablation, in which heat energy is delivered in a precise and highly-controlled manner, and has been used to treat Barrett’s esophagus for more than fifteen years. HALO ablation technology can completely remove the diseased tissue without damaging the normal underlying structures of the throat.

Clinical studies have demonstrated the Barrett’s tissue can be completely eliminated with the HALO ablation technology in 98.4% of patients. In March of 2011, the American Gastroenterological Association (AGA) issued the AGA Medical Position Statement on the Treatment of Barrett’s Esophagus. The guideline recommends removal of precancerous cells in patients with confirmed high-grade Barrett’s esophagus utilizing endoscopic eradication therapy, such as radiofrequency ablation (RFA) technology as delivered by the HALO Ablation System.

This HALO Ablation Therapy procedure is performed in conjunction with an upper endoscopy in an outpatient setting and no incisions are involved. The procedure lasts about 15 minutes.  At this time, The Bon Secours Harbour View Endoscopy Center is the only facility in Hampton Roads to offer this therapy.

What happens if Barrett’s esophagus goes untreated?

Untreated Barrett’s esophagus can advance from its earliest stage of intestinal metaplasia to low or high-grade dysplasia, and result in the development of a type of esophageal cancer called adenocarcinoma. Patients with intestinal metaplasia have a combined risk of 1.4% per year of progressing to high-grade dysplasia or cancer, which may result in an esophagectomy procedure. The majority of patients who develop an advanced esophageal cancer are unaware that they have Barrett’s esophagus.

How can patients find out more about the ablation procedure?

If you suspect that you have GERD or Barrett’s Esophagus we recommend that you speak with your primary care physician. Your doctor may refer you to a specialist, like those at the Bon Secours Harbour View Endoscopy Center for further evaluation.

+ Learn about the Bon Secours Harbour View Endoscopy Center
+ Read more articles on Cancer Care

Source: BÂRRX Medical, Inc. develops endoscopic treatment solutions for Barrett’s esophagus and other chronic gastroenterological diseases. Barrett’s is a precancerous condition of the lining of the esophagus (swallowing tube) caused by gastroesophageal reflux disease, or GERD. The company’s HALO90, HALO90 ULTRA and HALO360+ ablation catheters, driven by the HALOFLEX ablation system provide a uniform and controlled ablation effect, which removes diseased tissue and allows re-growth of normal cells. www.barrx.com.

29 thoughts on “HALO Ablation Technology: Treating Barrett’s Esophagus

  1. Debbie

    I am going to have the Halo Ablation done. Can anyone tell me what is the recovery time after this procedure. Meaning will I be on liquids? And how long with I be on liquids? Do you miss work? Are you in pain after the procedure?

    I have been fighting Barretts for years now and have metaplasia, but no dysplasia. (I don’t think).

    dazorra@gmail.com
    Thank you.

    1. BSHR Post author

      After the procedure, most patients report mild discomfort lasting two to five days. This discomfort consists mostly of a sore throat, pain and/or difficulty with swallowing, and/or chest discomfort. Typically patients do not experience any chest pain by the eighth day following the procedure.

      Your doctor can best advise you as to what to expect regarding pain and discomfort during and after the procedure. It is important to follow your doctor’s post-procedure instructions and take prescribed medications as directed to aid healing and minimize discomfort.

    2. Elaine

      In response to your question…..I had the Halo 90 June 9,2011. I had a tough first day, with pain front and back. Each day I felt a bit better and took it easy. I followed a clear liquid diet for over 24 hours, then started a soft diet. I’m still not too sure about which food to eat, but have looked up full soft diet on line which helped. Today is day three and I still have back and front discomfort. I was given no pain meds but take Carafate before meals and at bedtime. I also took Maalax mixed with Lidocaine as needed for the first few days, which helped. THis procedure was a big deal in my eyes and hope I heal well. I will have the second Halo on Aug 4. Good luck to you!

    3. jan kelleher

      Hi, My husband just had the Halo 360 performed this past Monday, Sept. 16, 2013. He did very well with the procedure. He did have a bad headache afterwards. Yesterday he complained that his back and chest hurt, which, from what I have researched, is normal. I was surprised that his throat didn’t hurt alot, just a little discomfort.
      The thing that upset me, was, I was told he should have clear liquids the rest of the day and by evening he could have a sandwich if he felt up to it. There was no mention that he should stay on a soft food diet for several days (which I highly suggest you do). Now, 3 days later I find this out, by doing my research. So for the next few days it will be soft foods only. About the work, he took 3 days off, and probably should stay home another day or so, but he thinks he will feel up to it by morning. Everyday he gets a little better. He never once had any trouble swallowing so that is a plus.
      Good luck to you with your procedure.
      Jan

  2. Michael Parker

    After 6 weeks post halo ablation, I am not swallowing normally and gagging. I had a nissen fundop surgery 9 years ago, could my recent ablation have disrupted that previous “wrap” surgery in any way? Has anyone heard of 1-2 month recovery? Could the ablation device have injured my swallowing ability or burned me internally?

    I have an endo evaluation after 2 full months. What should our plan be if I am still not swallowing normally? I am sorry I ever did this procedure at this time. Don’t know what to do. Any advice out there?

    1. BSHR Post author

      Michael,

      If you are having these issues and such intense discomfort we recommend that you call your physician right away and ask for an earlier appointment; s/he can give you a physical evaluation and more thorough follow-up!

  3. Elaine

    I’m the lady that had the Halo on June 9th. This is two weeks and I refilled my Carafate, because, I am having trouble getting more solid food down. I still eat mostly soft food and take small bites of cottage cheese, tuna and egg salad, and the like. I have had no meat as of yet, and bread is hard to swallow, but, I got those very thin Sandwich breads, which seem to go down ok, slowly.

    I guess I’m getting impatient, and feel I should be able to eat almost anything, except of course, meats and heavy breads… I have no discomfort, at this point. When food seems to stick, I get hiccups and have to drink milk with the food…

    The area I had ablated was the size of a finger nail, so I can’t understand why I’m still having problems eating. I was told by the office nurse to call next week if I’m still having a problem.

    1. BSHR Post author

      Elaine,

      If you continue to experience discomfort you should definitely call your doctor’s office to schedule a follow-up.

      Please keep us updated on your recovery; you’re in our thoughts!

  4. Elaine

    Thanks, BSHR. I seem to be doing better; however, today I took a Vitamin E and it got stuck in my throat or esophagus and it was very scary. I was making terrible uncontrollable sounds with saliva coming up. It took several minutes before it went down. I was upset and shaky afterward… but ok. I’ll see how I do on Monday and call the doc.

  5. Elaine

    July 10th and I’m not any better. Saw the doctor 2 weeks ago and he advised to stay on the Carafate, take small bites, have milkshakes, and the like. He will be returning from vacation tomorrow and I will call him. I have not been able to eat eat solid food without it getting stuck. I’m having a terrible time with the hiccups when this happens. I had a SSBE with no Dysplasia. Now I’m wondering if this was such a good idea.

    I’ve lost about 7lbs so far, but feel ok. He needs to take a look and see what is going on.

  6. Pingback: Bon Secours 757 Good Health Blog | What to Expect Following a HALO Ablation Procedure

    1. Steve

      I just had the halo ablation procedure, I have had a tad bit of trouble on day one I had a fever doctor sent me in for a Cat Scan and that was normal now I am on antibotics. Today is the start of day three and the eating and chest pain seem to be improveing except for back pain. I had low grade dysplasia and my barretts was 3 and 1/2 long. Has any one had the operation to prevent the gerd from causeing barretts to return?

  7. jonathan

    I was diagnosed with barrett’s 3 years ago. Since that time I have had 3 follow ups, all so far showed improvement and no dysplasia. I am still interested in getting an ablation done in order to lessen my fear about this situation. I am in law school and should graduate May, 2012, but until that time I will not have any insurance, so I am thinking about having it done as soon as possible after graduation.

  8. Elaine

    Just an update:

    On July 18th I had a dilation of my esophagus. Post Halo 90 caused Stenosis, hence food getting stuck. It helped some.

    I continue on Carafate and Nexium twice daily. The Barrett’s is gone and this is good. The biopsy came back normal, but my esophagus had closed to 9mm and it should be 18mm. The doctor was able to open it to 16.5mm, but, as of today, I still have a problem with certain food sticking, so I have to drink plenty of liquid in-between bites.

    I saw my doctor this week and he scheduled another dilation for Sept. 6th. I hope this does it – I will not ok another dilation this year.

    Wish me luck!

  9. Joseph

    I was diagnosed with Barrett’s 3 years ago. My father died of esophageal cancer in 1984 at the same age as I am now. In September my GI recommended the Halo procedure. I had it done last Wednesday.

    All went well I was only out of work for 2 days. However, I am still having pain when I eat or drink – no matter what what it is: soft, semi-soft, warm, cold. I’m eating slowly and completely chewing up any semi solid foods before swallowing.

    I am still taking carafate before I eat and I have doubled my protonix.

    They did the lower part first. It is like the food goes down ok until it reaches the end of my esophagus, then I get a real sharp pain in my whole chest for about 5-10 seconds before it subsides.

    I seems to not be getting any better. Any suggestions?

    1. BSHR Post author

      Joseph,

      After a HALO procedure, patients may experience some chest discomfort and difficulty swallowing for several days. These symptoms usually resolve within 3-4 days.

      This recovery period usually includes a modified diet of liquid or soft foods. Patients are encouraged to eat several small meals and snacks throughout the day instead of three large meals. When swallowing is difficult, many patients can still manage soft, bland foods. Puddings, ice cream, and soups are nourishing and are usually easy to swallow. (Your doctor can advise you about these and other ways to maintain a healthy diet during recovery.)

      If you are still experiencing a great deal of discomfort after the procedure, you should call your doctor’s office and schedule a follow-up appointment. He or she may also be able to recommend eating strategies to help you swallow with less pain.

      Best of luck in your recovery – please keep us updated on your progress!

        1. BSHR Post author

          Joseph,

          We are so glad to hear that you’re doing better and swallowing normally again! Sometimes patients take longer to recover.

          We hope this is the last time you have to worry about Barrett’s!

          BSHR

          1. Joseph

            Well I have another treatment scheduled for the middle of January to do my upper esophagus.Then two months after that another treatment for my middle esophagus.Then about May possibly another treatment to get what is left. Then hopefully it will be over!

          2. Joseph

            Well, they did my upper esophagus on the 11th of Jan.

            It felt a little different from the last time. I had a headache for several days and it has still taken me about the same recovery rate as last time. The doctor told me that there was a little more tissue than he expected, and he would have to do another 360 in two months and then two more paddles two months apart.

  10. gale pullham

    for me it has been four days the pain is worse today than any nearly everything i swallow comes back up my headache has gone but i feel like a balloon ready to pop

    1. BSHR Post author

      Gale,

      If you are having so much discomfort we recommend that you call your physician’s office and tell them about your concerns and discomfort. They may recommend you schedule (or move up) your follow-up.

      We hope you feel better – please keep us updated on your progress!

  11. VIOLA

    I had my Halo 360 procedure yesterday. I have a problem swallowing liquids, so I have not been taking the Carafate. I am doing okay, with just the normal things that I read on here that happen. I am drinking milk & eating little bits of ice cream. Will this help coat the area since I am not taking the Carafate? I know I am not suppose to throw up, and I am almost certain that if I take the Carafate I will throw up.

  12. bobgil

    5 days post halo. Still on soft food diet and I still get pain whilst eating. Otherwise, dont get much pain during the day or niight. Intially, after the procedure, I felt sick, but this was probably due to sinus problems..At that point the pain could be described as really bad indegestion. Think all the websites underestimate the recovery time with this. Can’t see me being off a soft food diet, in 2 days.and back to normal, in 2 weeks. I think its going to take a while longer.

  13. Marion Kenney

    I had two halo ablations this past summer. I found that it took a full 6 weeks before I could swallow most foods. I still had some difficulty at this point. The pain from the procedures lasted anywhere from 4-10 days. I found that I had intermittent pain after the 3rd day. So, I took my medication as needed. I’ve now had my follow up endoscopy with a stretching. After about a good 10 days, I can swallow anything. I can’t and never will eat ice cream again. For some reason, my body makes it come right back up. It never gets through my esophagus. I can live without it though, lol.
    Good luck to everyone who goes through this. : )

    1. BSHR Post author

      Marion,

      Thank you so much for sharing your story! We love to hear from patients who have had the procedure – good and bad! We’re glad to hear that you’re doing well. Although – no more ice cream?! Haha! Keep us updated on your progress!

      Best,
      BSHR

  14. Brenda

    I just had my second HALO Ablation Procedure done 5 days ago. The first treatment went well, was even eating soft noodles 1 day later. This time however is quite different. When I woke up in recovery I was in extreme pain. The roof of my mouth was blistered and my eyes, ears, throat and even teeth hurt really bad all on the right side of my face. For the first couple of days I was doing good to get the medicines down let alone any kind of water or broth. My neighbor called the doctor for me since I couldn’t even talk. He said it wasn’t normal for me to be having these reactions. Yesterday (day 4) she went and picked up an antibiotic the Dr. prescribed thinking my sinuses are infected. It does feel like an extreme sinus infection on top of the pain from the blistering on the roof of my mouth and the procedure itself. I went in the procedure with absolutely no issues and came out with this so I know it has to be from the procedure. Has anyone else had problems like this? I’m still having trouble talking and swallowing am having to take pain meds every 4 hours. I’m just curious why the sinus problems and why is the roof of my mouth blistered just like my esophagus?

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