Date: 4/7/2006

St. Mary Medical Center offers procedure to relieve GERD, prevent cancer

Physicians at St. Mary Medical Center in Hobart are being proactive when it comes to Gastro-Esophageal Reflux Disease, or GERD, especially because doctors now know that the acid reflux and subsequent heartburn condition is more dangerous than they once thought.

Those who suffer chronic GERD have a high likelihood of developing Barrett’s esophagus — a precancerous condition that occurs in the body’s “food tube” after it is continually subjected to the acids present with GERD. Those who have Barrett’s esophagus and leave it untreated have an increased likelihood of developing esophageal cancer.

Gastroenterologists at St. Mary Medical Center in Hobart are the only specialists in Northwest Indiana to offer a procedure using the HALO360 System, which removes the thin layer of diseased Barret’s cells from the esophagus, allowing regrowth of healthy, normal cells.

BÂRRX Medical, Inc., developed the HALO360 System for treating this dangerous condition. Physicians hail the system superior to current treatments for Barrett’s esophagus because it nets fewer complications but still provides a uniform, effective treatment.

Most common among middle-aged and older white males, Barrett’s esophagus affects approximately 3 million U.S. adults. While about a million patients with Barrett’s are in surveillance to monitor disease progression (“watch & wait”), it is believed that many more have the disease and don’t know it.

Barrett’s esophagus is caused by injury to the esophagus resulting from chronic GERD. According to an article in Gastrointestinal Endoscopy, about 13 percent of GERD sufferers have the condition.

The scary thing is that they probably don’t know it, says Peter Mavrelis, M.D., a gastroenterologist at St. Mary Medical Center.


“While heartburn and acid reflux symptoms might be relieved when people are treated for GERD, they cannot feel that the cells lining the esophagus have undergone genetic changes that make them more prone to developing cancer,” Mavrelis says. “They cannot feel that they have Barrett’s esophagus.”

The inner lining of the esophagus is normally composed of short, squat cells known as squamous cells. With prolonged acid exposure, these short cells can undergo a change and transform into taller columnar cells called Barrett’s metaplasia. These cells are vulnerable to further changes and therefore can set the stage for cancer.

“I can tell just by looking into someone’s esophagus with an endoscope if they have Barrett’s esophagus. The lining looks salmon-colored rather than a duller pink. We can confirm the diagnosis with biopsy,” Mavrelis says.

With the Halo procedure, first the gastroenterologist inserts a catheter (thin tube) into the esophagus to size the area. The physician then inflates a balloon to fit the diseased area, and with the energy controller, delivers short controlled pulses of radio frequency (RF) energy through the catheter and balloon. The pulses remove the diseased Barrett’s cells, making room for new, healthy tissue to grow back.

“This is a much better option that what existed before,” says Ranga Kota, M.D., a gastroenterologist who performs the procedure at St. Mary Medical Center.

One treatment for Barrett’s, called photodynamic therapy, poses the risk of stricture, or scarring and narrowing of the esophagus, says Ahmad Shughoury, M.D., who also performs the procedure using the HALO360 System. Esophageal mucosal resection — or surgery to remove the diseased portion of the esophagus — carries with it an increased risk of bleeding and a longer hospital stay, he said.

After the procedure, patients can expect to have a sore throat that is similar to what they feel with acid reflux disease. Medicines to control acid reflux are doubled for the next two weeks, and the patient is on a liquid diet for a day after the procedure. In three months, patients are checked again and the procedure may be repeated if necessary.

The HALO360 System doesn’t come completely without risk. Bleeding, discomfort and infection are the usual risks for just about any procedure. But Mavrelis says there are few, if any, contraindications for this procedure, and unlike others, it may be repeated if necessary.

BÂRRX Medical, Inc. is a medical device company, founded in 2000 to develop solutions for Barrett’s esophagus.