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A Favorable Response of Dysplastic Barrett’s Refractory to Ablation Therapy Only after Initiation of an Alginate Solution as Add-on Therapy
Mark M Brodie, Puja S Elias*, Mohamed Khalaf and Donald O CastellDepartment of Gastroenterology, Medical University of South Carolina, Charleston, South Carolina, USA
- *Corresponding Author:
- Elias PS
Department of Gastroenterology, Medical University of South Carolina
Charleston, South Carolina, USA
Tel: 8438760783
E-mail: eliasps@musc.edu
Received date: September 20, 2017; Accepted date: September 27, 2017; Published date: October 05, 2017
Citation: Brodie MM, Elias PS, Khalaf M, Castell DO (2017) A Favorable Response of Dysplastic Barrett’s Refractory to Ablation Therapy Only after Initiation of an Alginate Solution as Add-on Therapy. J Gastrointest Dig Syst 7:530. doi:10.4172/2161-069X.1000530
Copyright: © 2017 Elias PS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Alginates have been shown not only to be beneficial in their relief of symptomatic post-prandial gastroesophageal reflux, but there is also evidence that they may inhibit reflux, including bile acids and pepsin, and in turn attenuate and even prevent the activation and up-regulation of molecules associated with the development of metaplasia and cancer of the esophagus. Here we present the case of a patient with Barrett's esophagus with high-grade dysplasia (HGD) which was initially unresponsive to endoscopic radiofrequency ablation therapy and cryotherapy for highgrade dysplasia. Following initiation of therapy with an alginate solution in addition to twice daily proton pump inhibitor (PPI) therapy, the patient showed a favorable response and eventual complete eradication of his dysplastic Barrett's. The patient's course is suggestive that the alginate solution, through reflux inhibition, prevented persistent esophageal cell changes which occur secondary to gastric and bile acid exposure, thus allowing development of neosquamous epithelium. This case is intriguing with regard to the role of alginates in creating a favorable environment for esophageal healing when treating Barrett's esophagus with high-grade dysplasia.
