A swallowable, capsule-sponge device used to sample biomarkers offers a reliable, noninvasive alternative to endoscopy for diagnosing Barrett's esophagus, according to a new guideline from the American College of Gastroenterology.
In addition, the guideline recommends that patients with Barrett's esophagus with segments of less than 3 cm be screened every 5 years; but if their Barrett's esophagus segments are 5 cm or greater, they should be screened every 3 years.
"We don't want to scope everyone for the lowest risk of cancer," lead author Nicholas J. Shaheen, MD, MPH, chief of gastroenterology and hepatology at the University of North Carolina School of Medicine in Chapel Hill, told Medscape Medical News.
"The traditional way to diagnose Barrett's esophagus is by upper endoscopy, but it's expensive and not available everywhere," he said. "One big change since the last iteration of this guideline is that there's been a development of nonendoscopic screening modalities."
The guideline was published in The American Journal of Gastroenterology.
Progress With Swallowable Devices
Solid evidence supports the Cytosponge, a capsule containing a compressed spherical polyurethane sponge attached to a string. The sponge expands to a sphere when the capsule dissolves after being swallowed, Shaheen said.
When withdrawn, the sponge contains esophageal cytology samples that can be used to identify biomarkers for Barrett's esophagus, either the protein trefoil factor 3 expressed in intestinal metaplasia or methylated DNA markers associated with Barrett's esophagus mucosa.
