The course of pain and dysphagia after radiofrequency ablation for Barrett's esophagus-related neoplasia

Abstract

Background Radiofrequency ablation (RFA) is effective for eradication of Barrett s esophagus (BE) neoplasia, but little is known on the course of pain and dysphagia after RFA. We aimed to describe the course of post-RFA symptoms and to identify possible associated risk factors. Methods In this multicenter, observational cohort study, all RFA procedures registered in a prospective database were included. Patient and treatment characteristics were collected from medical records and patients self-registered post-procedural symptoms in electronic symptom diaries for 14 days. Mixed model regression was used for the analyses. Results In total, 255 diaries were completed. Post-RFA pain was reported for 95% (95 %CI 93 98) of procedures (median duration 14 days; 25th 75th percentiles [p25 p75] 11 14) and major pain for 64% (95%CI 58 69; median duration 8 days, p25 p75 3 13). Post-procedural pain significantly increased with BE length, younger age, and no prior ablation. Dysphagia was present after 83% (95 %CI 79 88) of procedures (median duration 13 days, p25 p75 9 14). The risk of dysphagia decreased with age and increased when patients experienced more pain. Conclusions RFA treatment for BE-related neoplasia seems a significant burden for patients, and post-procedural symptoms should be taken into account when counseling patients before starting endoscopic eradication therapy.