Cytosponge

Cytosponge is a new diagnostic test being introduced by NHS Scotland to identify important oesophageal conditions such as Barrett’s oesophagus.

Identifying cell changes in screening is important to ensure conditions such as Barrett’s do not progress to become oesophageal cancer. Screening allows cell changes to be identified and simple, curative treatment to be offered.

The Cytosponge is a small capsule which is attached to a fine string. After swallowing, the capsule coating (vegetarian gelatin) dissolves in the stomach to release a small brush which when removed allows cell collection from the lining of the oesophagus (gullet or food-pipe). These cells are then analysed for abnormalities.

The test itself takes around 15 minutes and has been found in several studies to be safe, well-tolerated and effective.

Why is it used?

It's common to suffer from heartburn and acid reflux, but this can occasionally lead to changes in the normal cells within your oesophagus (gullet), known as Barrett's oesophagus.

Very occasionally, Barrett's oesophagus may develop pre-cancerous or cancerous changes which may lead to oesophageal cancer (cancer of the gullet). Early detection of cell changes (dysplasia) in Barrett's oesophagus can make treatment much easier, and have less of an impact on the patient.

A Cytosponge test allows your doctor to investigate any symptoms and help you manage them.

Taking medications before your test

If you have been selected for the test, your clinical team will provide more details on what to do if you are taking medication.

On the day of your test

You should also bring a list of your usual medications and your consent form to your appointment.

You can wear your normal clothes to your appointment and you will be provided with a disposable bib.

You do not have to bring anyone else with you as you will not be sedated. There are also no effects from the test which would stop you from using public transport or driving to your appointment.

At the hospital or clinic

Ensure that you arrive on time for your appointment, but do not arrive early. This allows the number of patients within the clinic or hospital to be managed more easily.

Your appointment will last around 30 to 60 minutes.

If you have any questions when you arrive, you can ask the nurse as you check in.

The Cytosponge Test

Before your test, a member of the nursing team will collect you from the waiting room to take you to the clinic area.

You will be asked some questions to make sure you are ready for your test.

You’ll be asked to sit in a chair and staff will make sure that you are comfortable.

You will then be asked to swallow the Cytosponge capsule and string, with some water. The end of the string is attached to a piece of card which the nurse will hold on to.

It will take the capsule around seven and a half minutes to dissolve completely, and then the sponge will be released.

The nurse will then remove the sponge from your stomach through your gullet, by pulling the string quickly and gently.

The test should not be painful, but you may feel a slight burning feeling inside your gullet when the sponge is being removed. This will only last a few seconds.

You will be given the option to have a local anaesthetic spray into your throat before the sponge is removed, as some patients may find the last step uncomfortable. If you choose to have the local anaesthetic spray, the nurse will make sure you do not have any allergies or are taking any medication that may interfere.

After your appointment

You will be able to go home straight after you’ve had your test.

If you had a local anesthetic spray, it will cause a numb feeling in your throat that will soon go away. For safety reasons, you’ll be asked not to eat or drink for 30 to 60 minutes after the test. After this, you can eat and drink as normal.

If you have a sore throat after the test, you can suck on a throat lozenge or sweet to soothe it.

Non-urgent advice: If you experience any severe pain or a lot of bleeding

You should contact the clinic using the contact details on your referral letter.

If it is outside of normal opening hours, you should phone 111 and tell them that you have had a Cytosponge test.

Getting your results

Your clinical team will be in contact with your results when they are available.

Alternatives to Cytosponge

If for any reason you do not want to have a Cytosponge test, then an endoscopy will be offered. There will be a longer waiting time for an endoscopy due to the ongoing coronavirus (COVID-19) pandemic.

If you want to discuss an alternative, you should speak to your doctor.