Esophageal Treatments

Many esophageal conditions can be managed successfully without surgery. At MedStar Health, we offer a range of medications and nonsurgical therapies designed to ease your symptoms and improve your quality of life. Conservative treatment options for esophageal conditions may include:

• Acid-reducing medications: Antacids, H2 blockers, and proton pump inhibitors (PPIs) may help control acid reflux and protect your esophagus from damage.
• Steroids and allergy medications: These reduce inflammation caused by conditions like eosinophilic esophagitis.
• Lifestyle and dietary changes: We work with you to identify foods and habits that may worsen your symptoms. Simple changes, like eating smaller meals, avoiding certain triggers, and adjusting meal timing, can make a big difference.
• Swallowing therapy: For some motility disorders and dysphagia, working with a speech or swallowing therapist can improve muscle function and ease swallowing difficulties.

We personalize your treatment to get you feeling better with the least invasive approach possible.

At MedStar Health, we often use advanced endoscopic procedures to treat esophageal conditions without the need for traditional surgery. These treatments are done using a thin, flexible tube called an endoscope, which we gently guide through your mouth and into your esophagus. The endoscope has a camera and special tools that let us see and treat the problem with precision.

Most endoscopic procedures are outpatient, so you can go home the same day and recover more comfortably.

Endoscopic Mucosal Resection (EMR)

Endoscopic Mucosal Resection, or EMR, is used to remove abnormal or pre-cancerous tissue (dysplasia) or early-stage cancer from the lining of the esophagus. During this procedure, we carefully remove the affected tissue through the endoscope, either to test it or to prevent further problems.

You’ll be placed under anesthesia, so you won’t feel any discomfort during the procedure. Afterward, your doctor may prescribe medication and ask you to follow a special diet for a short time to help your esophagus heal.

Endoscopic Submucosal Dissection (ESD)

Endoscopic Submucosal Dissection (ESD) is an advanced procedure that lets us remove larger growths or tumors in one piece. Removing the entire growth in one piece gives your doctor a better chance of fully eliminating abnormal tissue and reduces the risk of the problem coming back. In many cases, ESD may help patients avoid more invasive surgery.

Like EMR, ESD requires you to be under anesthesia. Some patients go home the same day, while others may need a short hospital stay, depending on how much tissue is removed and your overall health. After the procedure, your care team will give you medication instructions and may recommend a temporary change in your diet to support healing.

Ablation therapies (Radiofrequency and cryoablation)

Ablation is a minimally invasive treatment that uses either heat or cold to destroy abnormal or precancerous cells in the esophagus. It’s often used for conditions like Barrett’s esophagus or early-stage esophageal cancer and may be an option if the tissue can’t be removed with procedures like EMR or ESD.

At MedStar Health, our team was the first in the area to offer advanced ablative therapies that help treat Barrett’s and reduce the risk of esophageal cancer. There are two main types of ablation we offer:

• Radiofrequency ablation (RFA) uses controlled heat to remove abnormal cells
• Cryoablation uses a cooling spray to freeze and destroy damaged tissue

Both methods are done using an endoscope, and most patients go home the same day. Your doctor will recommend the type of ablation based on your condition and treatment goals.

Esophageal dilation

If your esophagus becomes too narrow or tight, it can make swallowing uncomfortable or even painful. This can happen for a number of reasons, such as scar tissue, inflammation, or chronic conditions such as eosinophilic esophagitis, achalasia, or GERD.

Esophageal dilation is a quick, nonsurgical procedure that gently stretches the narrowed part of your esophagus. Using a thin, flexible tube called an endoscope, your doctor will guide a small balloon or dilator into place and slowly expand it to widen the passage. This helps food and liquid move more easily from your mouth to your stomach.

Most dilations are done with mild sedation, and you can usually go home the same day. In some cases, your doctor may recommend more than one dilation over time to keep your esophagus open and your symptoms under control.

Learn more about endoscopic dilation

Esophageal stenting

If part of your esophagus becomes too narrow or blocked, it can make eating and drinking difficult or even unsafe. This is often caused by scar tissue, a tumor, or another condition, such as a gastrointestinal motility disorder. Esophageal stenting is a minimally invasive option that helps keep the esophagus open so you can swallow more comfortably.

During the procedure, your doctor places a small, flexible tube called a stent into the narrowed area using an endoscope. Once in place, the stent gently expands to support the walls of your esophagus and improve the flow of food and liquids.

This procedure is typically done with light sedation or anesthesia, and most patients go home the same day. Depending on your needs, the stent may be temporary or permanent. Your care team will let you know what to expect and guide you through any diet or medication changes afterward.

Learn more about endoscopic stents

Electrocautery

Sometimes, extra or damaged tissue inside the esophagus can cause narrowing, blockages, or discomfort. Electrocautery is a precise treatment that uses a small, controlled electrical current to remove this tissue safely.

During the procedure, your doctor uses an endoscope to reach the affected area, then applies gentle heat to carefully remove the unwanted tissue. This method is especially helpful for treating strictures (narrowing) or certain abnormal growths.

Electrocautery is typically done on an outpatient basis, and you’ll be lightly sedated or under anesthesia to keep you comfortable. Most people are able to go home the same day and return to their usual activities shortly after.

Fundoplication

If you have long-term acid reflux (GERD) that doesn’t improve with medication or lifestyle changes, fundoplication may be a good option. This minimally invasive surgery helps prevent stomach acid from flowing back into your esophagus.

During the procedure, your surgeon wraps the upper part of your stomach around the lower end of your esophagus. This strengthens the valve between your stomach and esophagus, helping to reduce or stop acid reflux. It can also help improve swallowing and reduce symptoms like heartburn, coughing, or chest discomfort.

Most fundoplication procedures are done using small incisions (laparoscopically), so recovery is faster and pain is minimal. Many patients go home the same day or after a short hospital stay.

LINX® Reflux Management System

The LINX® Reflux Management System is a minimally invasive option for treating chronic acid reflux (GERD), especially when medications aren’t enough. It’s a small device that helps keep stomach acid from backing up into your esophagus.

The LINX system is made up of a ring of tiny magnetic beads placed around the lower end of your esophagus. The magnets are strong enough to keep the valve between your stomach and esophagus closed—preventing reflux—but flexible enough to open when you swallow food or drink.

The procedure is quick and typically done using small incisions. Most patients go home the same day and recover with minimal discomfort.

Heller Myotomy

Heller myotomy is a minimally invasive surgery used to treat achalasia and other esophageal motility disorders that make swallowing difficult—a condition known as dysphagia. These disorders occur when the muscles in the esophagus don’t work properly, often causing food or liquids to get stuck or move slowly into the stomach.

This procedure can be performed using small external incisions (laparoscopically) or through the mouth using an endoscope. In either case, your surgeon cuts the tight muscle at the lower end of the esophagus to improve the flow of food.

Following the procedure, most patients have a brief stay in the hospital. You may need to follow a soft food diet for a short time after surgery.

Peroral Endoscopic Myotomy (POEM) (Coming soon)

POEM (Peroral Endoscopic Myotomy) is a highly advanced, endoscopic procedure used to treat achalasia and other esophageal motility disorders that cause trouble swallowing. POEM is performed entirely through the mouth with no external incisions at all.

Using an endoscope, your doctor creates a small tunnel within the wall of the esophagus and carefully cuts the tight muscle that’s blocking food from passing into the stomach. Because there are no outside cuts, POEM often offers a faster recovery with less discomfort.

Most patients go home the same day or after a short hospital stay. You’ll be given diet and recovery instructions to help your esophagus heal properly.

Diverticulectomy/Myotomy

A diverticulum is a small pouch that can form in a weak spot of the esophagus. One common type, called Zenker’s diverticulum, can cause symptoms like difficulty swallowing, coughing, or even infections if food or liquid gets trapped.

To treat this, your doctor may perform a diverticulectomy, which removes or reduces the pouch, often using an endoscope through the mouth for a minimally invasive approach. Sometimes, a myotomy is also done to cut the tight muscle that’s causing pressure and contributing to the pouch.

Both procedures usually require general anesthesia and are done with advanced, minimally invasive techniques to help you recover faster. After surgery, you may need medications or a special diet for a short time while your esophagus heals.