Beyond Heartburn: Screening Barrett’s Esophagus With Next-Generation Capsules

From Endoscope to Capsule

While standard upper endoscopy remains gold standard, swallowable optical capsules now capture high-resolution images of the distal esophagus without sedation.

Who Should Consider It

• Chronic GERD >5 years plus at least two risk factors: age >50, male sex, Caucasian ethnicity, central obesity, smoking history.
• Patients who decline or cannot tolerate conventional endoscopy.

Advantages

• No anesthesia; procedure completed in primary-care setting.
• Real-time AI can flag columnar epithelium suggesting Barrett’s change.
• Lower cost improves population-level screening adherence.

Limitations

Biopsy is still required for definitive diagnosis. However, capsule findings can triage high-risk patients for priority endoscopy.

Key Takeaways

• Capsule screening broadens access and may increase early detection of dysplasia.
• Combining capsule imaging with salivary biomarkers enhances specificity.
• Telehealth models allow same-visit consult and prescription of acid suppression therapy.

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