For patients

The Cytosponge is a capsule on a string, which expands into a small sponge in the stomach. The Cytosponge test can find conditions of the oesophagus that are more common among people who have heartburn, reflux and/or indigestion.

Do you want to read more about the Cytosponge test? Then go to All about the Cytosponge.

Acid reflux explained

Acid reflux is when stomach acid flows up the oesophagus, also known as food pipe or gullet. This can cause pain in the chest, neck or throat which is commonly called heartburn, a sour taste in the mouth especially when lying down, or a burning sensation.

Acid reflux is a very common condition among the British population, with up to 44% of adults complaining of reflux symptoms at least once a month, 20% experiencing symptoms more than twice a week and about 7% having symptoms on a daily basis. 

The Cytosponge: A test for early detection

The Cytosponge is a simple and quick test for the detection of Barrett’s Oesophagus, a condition that can develop in patients with long-standing acid reflux. Barrett’s Oesophagus is characterised by changes in the oesophageal cell lining that could develop into cancer if not detected in time. The Cytosponge reliably detects cells pointing towards such changes in the oesophagus. By detecting Barrett’s Oesophagus, the Cytosponge can thus contribute to the prevention of oesophageal cancer in those at risk.

Benefits and risks of the Cytosponge test

Benefits:

• The Cytosponge is much less uncomfortable than an endoscopy. 

Usually, patients with longstanding acid reflux receive an endoscopy. This is a procedure during which a tube is inserted into the oesophagus to look a the cell lining and to take biopsies. Endoscopies usually require sedation. The Cytosponge test can be performed without the need for sedation. Being the size of a regular pill, the sponge is easy to swallow. Retrieval is quick and much less uncomfortable than an endoscopy. 

• The Cytosponge can be done at the GP’s surgery.

For an endoscopy, an appointment at the hospital is needed. The Cytosponge test, on the other hand, can be performed at the GP’s surgery by a trained nurse. 

• The Cytosponge is much quicker than an endoscopy. 

An endoscopy usually takes 15-20 minutes, plus a recovery period of 24 hours. The Cytosponge is done in 5-7 minutes and does not need a recovery period. 

Risks

• Detachment of the thread

It is very unlikely that the sponge detaches from its thread mid-procedure. However, if the thread does break, the sponge remains in your stomach, without any harm. You will then have it removed via endoscopy the same day. 

• Side effects during the procedure

Some patients will experience discomfort by the thread at the back of their throat. If so, sipping water to keep the thread lubricated can help. Retrieving the Cytosponge is uncomfortable, but very brief. You will feel a scratching sensation in your throat for about a second or two. Some patients might gag during retrieval, too. There is a spray to prevent discomfort, but most patients don’t find that necessary. 

• Side effects after the procedure

After the procedure, you might have a sore throat for a couple of hours. This can be soothed with a sweet, a lozenge or some tea, for example.

• Your GP will discuss the option of taking the test with you.
• You will receive a leaflet with the most important information about the test that you can read before the test. You can also access this leaflet at All about Cytosponge.
• We ask you to not to eat or drink for 4 hours before the test.
• If you take any medication that acts to thin your blood, it might be necessary to temporarily stop this prior to the procedure, based on advice from your doctor.
• After the test, you will be able to continue with your day as normal.

You will be asked to swallow the Cytosponge capsule which has the size of a paracetamol tablet. The nurse will support you during the swallowing process and give you precise instructions. After you swallow the capsule it takes between 5 to 7 minutes until the capsule dissolves in your stomach and the Cytosponge expands. During these 5 to 7 minutes you have to sit up straight and wait.

There are several things you can do to take your mind off the procedure:

• You are allowed to talk during the procedure. The nurse will offer to talk with you or you can bring a close family member or a good friend to have a short conversation. 
• Bring your tablet or phone to the procedure to distract yourself. You could, for example, download a video or text with a close friend.
• Listen to some music during the procedure. You could download some relaxing music on your phone. 

All suggestions are optional and not a necessity to successfully undergo the Cytosponge test.

Tips & Tricks for after the procedure

After the retrieval of the Cytosponge, you might experience a sore throat for a couple of hours. There are several options recommended to relieve the symptoms after the procedure:

• Drink a glass of water 
• Drink a cup of tea
• Eat an ice lolly
• Eat a sweet

What happens next?

• Processing of the sample

The Cytosponge collects cells of the whole gullet when it is retrieved. Then, the Cytosponge is sent to a laboratory to test for specific markers which are characteristic for Barrett’s Oesophagus. For more information about Barrett’s go to the Learn more about Barrett’s Oesophagus. 

• Receiving the result

Most patients receive a negative test result.

If you receive a negative test result you do not have to undergo any further testing. If your acid reflux symptoms persist you might be invited again for a Cytosponge test after a certain time period by your GP. 

You receive a positive test result

If you receive a positive test result, your GP will make an appointment at the hospital for an endoscopy. With the help of an endoscopy, the physician can confirm the test results of the Cytosponge and give further information on how extensive the lesion in your gullet is. If the endoscopy reveals a positive result for Barrett’s Oesophagus as well, you will enter a Barrett’s surveillance programme which recommends an endoscopy every 2 to 3 years.

For further information on Cytosponge test results go to All about the Cytosponge.