Capsule endoscopy for screening for short-segment Barrett's esophagus.
BACKGROUND
The rise in the incidence of esophageal adenocarcinoma has led to the development of new methods to screen for the precursor lesion, Barrett's esophagus.


OBJECTIVE
To evaluate the potential role of esophageal capsule endoscopy in identifying the presence of short-segment Barrett's esophagus.


METHODS
Patients with biopsy-proven short-segment Barrett's esophagus underwent esophageal capsule endoscopy. The images were reviewed by two expert observers with no knowledge of the purpose of the study. The data collected included transit time, quality of image, presence or absence of Z-line, Schatzki's ring, hiatal hernia, and Barrett's esophagus (long or short, definite or suspected).


RESULTS
Twenty patients were studied; in 18, the capsule passed into the stomach. Barrett's esophagus was identified or suspected in eight cases (44%) by one observer and three (16%) by the second (P= 0.14). Although the Z-line was seen in the 18 cases that were qualified by both observers, there was an agreement in only six cases as to whether it was regular or irregular. Erosive gastroesophageal reflux disease (GERD) was scored as present in three and absent in six patients by both readers. Nonexisting feline esophagus, varices, and distal esophageal stricture were suspected in one patient each.


CONCLUSIONS
Esophageal capsule endoscopy had a high interobserver variability and a low yield for short-segment Barrett's esophagus. Esophageal capsule endoscopy cannot be recommended for screening for short-segment Barrett's esophagus.
Michael E. DeBakey VAMC, and Baylor College of Medicine, Houston, Texas 77030, USA.
Waqar A
WA
Qureshi
Justin
J
Wu
Daniel
D
Demarco
Suhaib
S
Abudayyeh
David Y
DY
Graham
D000368:Aged; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000473:pathology; D053704:Capsule Endoscopy / Q000379:methods; D004945:Esophagoscopy; D006551:Hernia, Hiatal / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation