This large, single-center, prospective cohort study evaluated a non-endoscopic capsule sponge (CS) triage pathway for patients routinely referred with reflux symptoms over 4 years. The goal was to assess its impact on endoscopy utilisation, diagnostic yield, and long-term safety.
This large, single-center, prospective cohort study evaluated a non-endoscopic capsule sponge (CS) triage pathway for patients routinely referred with reflux symptoms over 4 years. The goal was to assess its impact on endoscopy utilisation, diagnostic yield, and long-term safety.
Among 871 patients who underwent capsule sponge testing, nearly 88% provided adequate samples. Importantly, 62% avoided endoscopy, and most of these low-risk patients were safely discharged. Abnormal CS results were seen in approximately 10% of patients and were strongly associated with significant pathology. One case of esophageal cancer, two cases of Barrett’s dysplasia, and 34 cases of Barrett’s esophagus were detected. The positive predictive value for Barrett’s esophagus in patients with abnormal CS was 43.5%, while the negative predictive value was high at 98.2%.
Long-term follow-up (over 2,000 patient-years) confirmed safety. Only a small proportion of patients with a negative CS who later underwent endoscopy for persistent symptoms were found to have Barrett’s or atrophic gastritis. Patient acceptability was excellent, with over 97% finding the test acceptable.
Overall, the capsule sponge pathway safely stratifies reflux patients, increases the yield of significant endoscopic diagnoses, reduces unnecessary procedures, and supports more efficient endoscopy resource utilization.
Introduction: Barrett's esophagus (BE) is the principal precursor of esophageal adenocarcinoma. Early detection of neoplastic transformation is essential for preventing cancer progression. This review discusses basal crypt dysplasia (CD), an emerging histological entity that may...
Introduction: Assessing esophageal clearance after peroral endoscopic myotomy (POEM) is essential for evaluating treatment success in achalasia. Timed barium esophagram (TBE) is the current standard, but high-resolution impedance manometry (HRiM) may provide a radiation-free physiological...
Introduction: Magnetic sphincter augmentation (MSA) has emerged as an effective surgical option for patients with gastroesophageal reflux disease (GERD) who continue to experience symptoms despite medical therapy. By augmenting lower esophageal sphincter function while preserving...
Introduction: Helicobacter pylori infection affects more than half of the global population and remains a major cause of peptic ulcer disease, gastric mucosal inflammation, and gastric cancer. Successful eradication is a cornerstone of gastrointestinal practice,...
Introduction: Helicobacter pylori Infection eradication after prior treatment failure remains a major therapeutic challenge due to increasing antibiotic resistance, poor tolerability of multidrug regimens and declining adherence rates. Simplified rescue strategies with improved safety and...
Introduction Helicobacter pylori Infection eradication is widely accepted as a key strategy for prevention of Gastric Cancer. Large meta-analyses have consistently shown reductions in gastric cancer incidence following eradication therapy, supporting global screening and treatment...
We are pioneers in clinical intelligence, dedicated to helping gastroenterologists harness the power of artificial intelligence to drive precision, efficiency, and patient growth.