Barrett’s Esophagus (BE) occurs when damaging acid reflux causes the lining of the esophagus to change from normal to pre-cancerous tissue. Although BE can be effectively treated with acid-blocking medications, some patients with more advanced disease often require endoscopic therapy to remove the abnormal tissue. While many experience successful outcomes with this treatment option, some 5 to 25 percent will redevelop the disease; recurrence puts patients at increasing high risk for esophageal cancer or adenocarcinoma. With a five-year survival rate of about 20 percent, this deadly cancer has increased by a factor of more than seven in the past 40 years. Many risk factors contribute to BE, including gender, with men are at higher risk than women; chronic heartburn and acid reflux, especially before age 30; and smoking. Interesting, the disorder has developed with increasing frequency in non-smoking young men between the ages of 20 to 45. Sri Komanduri, MD, Director of Interventional Endoscopy at Northwestern Medicine and his research team previously found that persistent acid reflux in patients who have undergone endoscopic therapy likely causes recurrent BE. Currently, these patients must undergo placement of an uncomfortable transnasal catheter over a 24-hour period to assess and measure persistent acid reflux. This testing helps gastroenterology specialists to determine the best treatment options: a combination of medications and endoscopic treatment or perhaps a referral for surgery. Due to costs and patient intolerance, though, this type of reflux testing has proven to be impractical. Studies of patients without endoscopically-treated BE have suggested consistent changes in the lining of esophageal biopsy samples, which strongly indicate uncontrolled acid reflux. Extrapolating from this observation, Dr....
Principal Investigator: Amanda Guentner, MD No one wants to hear the “C” word. Even the slightest hint of a cancer risk is, understandably, frightening—even when all signs point to a positive outcome. Chronic regurgitation of stomach acid can damage the esophagus and eventually lead to a condition known as Barrett’s esophagus (BE). Patients with BE are at risk for esophageal adenocarcinoma (cancer of the esophagus), which strikes about 3 to 4 Americans out of 100,000 each year. While a variety of advanced treatments such as endoscopic eradication therapy (EET) help to prevent cancer well before it ever starts, many patients overestimate their cancer risk. Being referred for treatment appears to further ramp up their anxiety. Despite patient education prior to and after EET, individuals facing a series of treatments often forget what they may have been told about their diagnosis, cancer risk and/or short- and long-term prognosis. This perceived lack of information, which has been linked to overall patient satisfaction, often pushes them over the top. Supported by the Digestive Health Foundation, researchers in Northwestern Medicine’s Division of Gastroenterology and Hepatology are evaluating the use of multimedia to enhance the patient experience pre- and post-EET therapy. Recent studies have shown them to be successful with patients who’ve undergone general and orthopaedic surgical procedures. The investigators plan to create an educational video for patients undergoing EET for Barrett’s esophagus through Northwestern’s Digestive Health Center and measure its impact on reducing patient anxiety. Led by GI fellow Amanda Guentner, MD, the team will produce a short video to reinforce the information patients typically receive during face-to-face consultations with their gastroenterologist and/or...
