Gastroenterology
option to undergo capsule sponge testing between scheduled endoscopic examinations. For the patients, the procedure is far less invasive and, for the trust, there is considerably less demand placed on endoscopy services. The capsule sponge component of the Barrett’s surveillance service is delivered almost entirely by specialist nurses, with consultants providing oversight rather than day-to-day management. This approach is particularly valuable for patients who struggle with the repeated gastroscopies required to monitor their condition. In these cases, capsule sponge testing helps to keep patients engaged with surveillance, offering reassurance when results are normal, and enabling timely escalation to gastroscopy services when dysplasia or other concerning findings are identified.
A blueprint for transformation The experience at West Suffolk Hospital is just one example of more than 70 sites across the UK where capsule sponge technology has served as a catalyst for wider service transformation, including national programmes in Wales and Scotland. The technology is reshaping upper GI pathways, enabling risk stratification for reflux, nurse-led care and Barrett’s surveillance outside of traditional endoscopy units. The team at West Suffolk Hospital have found capsule sponge technology has shown its greatest value not simply as an alternative diagnostic test, but as a means of enabling a fundamentally more efficient model of care. The pathway adopted there – combining a minimally invasive investigation with specialist nurse-led assessment, patient education and targeted follow-up – has reduced demand on endoscopy services, and simultaneously improved the care experience for patients living with reflux and Barrett’s oesophagus. This work builds on best practices already established by GPs and community diagnostic centres (CDCs), providing a more efficient diagnostic experience for patients. Pathway implementation required strong collaboration with primary care, which enabled wider conversations around reflux management, allowing GPs to understand how best to refer into the pathway. This cooperative approach highlights the importance of having frank, open conversations across the healthcare system to improve outcomes for patients. Overall, the transformation of reflux referral pathways with capsule sponge diagnostics offers trusts a tried and tested model for exploring more efficient ways of managing growing demand, providing a compelling example of how innovation can improve both service capacity and patient outcomes.
References 1. Zamani SA, Wu L, Black EL, et al. (2026). Integrated epidemiological and molecular data inform the relationship between precancer and cancer states of esophageal
adenocarcinoma.Nat Med 32, 1805–1816. Available at:
https://doi.org/10.1038/s41591- 026-04331-8
2. Beaton DR, Sharp L, Lu L, et al (2024). Diagnostic yield from symptomatic gastroscopy in the UK: British Society of Gastroenterology analysis using data from the National Endoscopy Database. Gut 2024;73:1421-1430. Available at:
https://gut.bmj.com/content/73/9/
1421.info
3. NICE (2015). Dyspepsia and gastro-oesophageal reflux disease in adults. Available at: https://
www.nice.org.uk/guidance/qs96
4. NICE (2024). Scenario: Dyspepsia - unidentified cause. Available at:
https://cks.nice.org. uk/topics/dyspepsia-unidentified-cause/ management/dyspepsia-unidentified-cause/
5. NICE (2026). Suspected cancer: recognition and referral. Available at: https://www.
nice.org.uk/guidance/ng12/chapter/ Recommended-actions-organised-by- symptom-and-findings-of-primary-care- investigations
6. Chimba C, Bannister P, Memon A (2021). Changing epidemiology and trends in incidence of oesophageal cancer in England, 1985- 2017,European Journal of Public Health, Volume 31, Issue Supplement_3, ckab165.230. Available at:
https://academic.oup.com/eurpub/ article/31/Supplement_3/ckab165.230/6406225
7. Oxford Cancer. Oesophagogastric Cancer Centre of Excellence.
https://www.cancer.
ox.ac.uk/research/networks/OCCE. Accessed 5th of February 2026.
8. NICE (2025). Gastrointestinal tract (upper) cancers - recognition and referral. Available at:
https://cks.nice.org.uk/topics/ gastrointestinal-tract-upper-cancers- recognition-referral/
9. IQVIA (2023). NHS England Cytosponge Evaluation for Routine Referrals. Accessed 22nd June 2026. Available at:
https://assets.ctfassets.net/ u7vsjnoopqo5/1B0eyxHtYMJofn82X3FMKi/ 8fe45baab4c4273837a534d45af85b6b/ cytosponge_evaluation_final_report_-_nhse_0. pdf
10. Unity Insights. (2023) Cytoprime Summary Report 2023. Accessed June 22nd 2026. Available at:
https://unityinsights.co.uk/our- insights/cytoprime/
CSJ
11. Solaymani-Dodaran M, Logan RFA, West J, et al. (2004). Risk of oesophageal cancer in Barrett’s oesophagus and gastro-oesophageal reflux. Gut 53:1070-1074. Available at:
https://gut.bmj. com/content/53/8/1070
About the author
Mr Craig Vickery is a Consultant General and Upper Gastrointestinal Surgeon at West Suffolk NHS Foundation Trust, specialising in the diagnosis and treatment of conditions affecting the oesophagus, stomach and gall bladder. His research interests include the quality of life in patients with gastric cancer and the incorporation of capsule sponge into referral pathways for patients with symptoms of gastro- oesophageal reflux. He is the clinical lead for diagnostics in the new hospital programme for Bury St Edmunds and endoscopy in a new CDC in Newmarket.
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