P221 What does gastroscopy show after normal cytosponge in patients with reflux symptoms? A 2 year prospective series

IntroductionWe established an early diagnosis Cytosponge service for patients routinely referred with reflux symptoms to aid early diagnosis, management and triage to gastroscopy. As Cytosponge samples the cardia and oesophagus only, distal pathology may not be detected without further investigation. This study evaluates the findings at gastroscopy in those with negative Cytosponge and persistent symptoms in a single site UK hospital who have 2 years of experience using Cytosponge.MethodsBetween November 2020 and January 2023, all patients routinely referred to the clinical service with reflux and heartburn symptoms were assessed promptly in a nurse-run clinic and offered Cytosponge as a first test. We excluded patients with known Barrett’s, cancer, fundoplication and strictures. Patients found to be trefoil factor 3 (TFF3) +ve, a marker for intestinal metaplasia (IM), had routine gastroscopy. Patients with atypia and/or p53+ve (markers for dysplasia) had urgent gastroscopy. Patients with other significant findings or persistent symptoms were offered investigation as appropriate. All patients were given lifestyle and management advice and were followed up by nurse-led telephone clinic