Barrett’s esophagus affects 200,000 Americans each year and occurs when the tissue of the esophagus changes into tissue similar to the tissue in the intestines. Often caused by acid reflux disease, Barrett’s can progress into cancer in as much as five percent of patients. This makes it extremely important for researchers to be able to identify which patients are at risk for cancer.
Currently the most common practice for monitoring patients with Barrett’s is the endoscopy. An endoscopy involves putting a small device with a camera down the throat to look at the tissue and take biopsies for lab analysis. While endoscopy is highly accurate, it is also expensive and time-consuming and may cause anxiety for the patient.
A study published in The Lancet Gastroenterology & Hepatologyin January 2017 looked into whether the Cytosponge, a non-endoscopic device, would be able to identify those with a low risk of Barrett’s progressing into cancer. Researchers looked at 468 patients who underwent the classic endoscopy and tested them using the Cytosponge. The Cytosponge consists of a pill on a string, which is swallowed. When the pill reaches the stomach, the capsule dissolves in five minutes and the sponge expands. The doctor then pulls the sponge out — collecting samples of the esophageal tissue upon exit. In combination with additional lab tests and risk-factor information (such as obesity, family history, and smoking), the researchers were able to accurately identify that 35 percent of the participants were at a low risk for developing cancer.
If these results can be duplicated in larger trials, the Cytosponge could end up being a very useful tool in monitoring patients with Barrett’s esophagus. It could also be used for diagnosing Barrett’s as well. Identifying patients who are at a low risk for cancer will save significant time and money by not monitoring those patients with endoscopy needlessly. Should the patient show markers for cancer with their Cytosponge test, they could always continue with the more invasive testing next.
Unlike the endoscopy, the Cytosponge test is done without any anesthesia. This can be extremely useful in the patient population that may be at a high risk for complications from anesthesia, such as the elderly and those with allergies or bad reactions to anesthesia.
Talk with your gastroenterologist about whether the Cytosponge is available in your area and if it would be a good choice for you. You can also check out this video on the Cytosponge procedure.
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Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma, and food allergies for the past 12 years. Jennifer also serves on the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).