Radio Frequency Ablation (RFA)

Radiofrequency ablation (RFA) is a medical technology that allows the delivery of heat generated by an electrical current in order to destroy (ablate) abnormal tissue. RFA can be performed during an upper endoscopy to treat abnormal esophageal tissue, such as in Barrett’s esophagus and other pre-cancerous lesions.

An upper endoscopy is performed and the abnormal tissue is identified. A special RFA catheter is advance through the endoscope and placed on the tissue. The catheter then heats up and destroys the top layer of tissue.

You prepare by not eating or drinking for 6 hours prior to the procedure. The preparation is otherwise similar to the instructions you will receive for the upper endoscopy.

The risks are similar to that of a regular esophagogastroduodenoscopy, but also include a rare chance (~5%) the tissue healing into a scar (or stricture) that leads to difficulty swallowing with a sensation that food can get stuck. This is often treated with using a balloon to stretch the scar wider again. There is also about 1% risks of causing serious bleeding, which is typically managed using the endoscope. There is a very rare (1 in 1000) chance of a hole being created in the tissue, which could require surgery.

There may be some pain while swallowing after the procedure. You will be given a medication sucralfate to coat the esophagus to be taken 4 times per day. You will also be given a medication to numb the esophagus before eating to minimize any discomfort.

Given the discomfort with swallowing, many people find limiting their food intake after the procedure helpful. This can be guided by your symptoms, but an example of how to advance your diet could include:

• Day 1: You will have nothing by mouth the day of your procedure.
• Day 2: You can have liquids and gelatins (eg: Jello, popsicles, or any thin liquid) the day following your procedure.
• Day 3: Advance diet to thick liquids (eg: soups, pudding, smoothies).
• Day 4-7: You can advance your diet to solids, as tolerated.