Screening for Barrett’s oesophagus with oesophageal capsule endoscopy in first-degree relatives of patients affected by Barrett’s oesophagus: Results of a pilot study

Background and study aimsBarrett’s oesophagus (BE) is one of the complications of gastro-oesophageal reflux disease (GERD). Oesophageal capsule endoscopy (ECE) has been proposed as a non-invasive investigation of oesophageal pathology. The aims were to evaluate the diagnostic yield of ECE in first-degree relatives of patients with BE and reflux symptoms and to assess prospectively the prevalence of BE in these conditions.Patients and methodsInclusion criteria were familial history of at least one first-degree relative with BE and typical reflux syndrome. Patients underwent ECE followed by oesophagogastroduodenoscopy (EGD). The ECE findings were compared with those during EGD.ResultsBetween February and October 2009, 18 patients were enrolled. Oesophagitis and endoscopically suspected oesophageal metaplasia (ESEM) were present, at ECE, in 7 and 11 patients, respectively. Intestinal metaplasia was histologically confirmed in eight patients. Sensitivity and specificity of ECE were, respectively, 86% and 91%, for oesophagitis, and 100% and 70% for ESEM; positive predictive value (PPV) and negative predictive value (NPV) were 86% and 91%, respectively, for oesophagitis and 73% and 100%, respectively, for ESEM. Prevalence of BE was 44%.ConclusionECE showed an optimal NPV for BE detection. Pending confirmation of these results, ECE could be proposed as a screening test in symptomatic relatives of patients with BE.