Minimally Invasive Molecular Approaches for the Detection of Barrett's Esophagus- High Grade Dysplasia and Esophageal Adenocarcinoma

This study explores the use of a minimally invasive screening tool (a sponge on a string device) to detect Barrett's esophagus and esophageal adenocarcinoma and to develop a laboratory test for the detection of Barrett's esophagus-high grade dysplasia and esophageal adenocarcinoma.

Inclusion Criteria: * Patient between the ages 18 - 90 * Patients with a BE segment \>= 1cm in maximal extent endoscopically * Histology showing evidence of intestinal metaplasia with or without presence of dysplasia * Undergoing clinically indicated endoscopy Exclusion Criteria: * Patients with a prior history of ablation (photodynamic therapy, radiofrequency ablation, cryotherapy, argon plasma coagulation). Patients with a history of endoscopic mucosal resection alone will not be excluded * Patients with a history of esophageal or gastric resection for esophageal or gastric carcinoma * Subjects with or without known evidence of BE (on history or review of medical records) * Pregnant or lactating females * Patients who are unable to consent * Patients with a current history of uninvestigated dysphagia (this does not apply to the brushings only portion of the study) * History of eosinophilic esophagitis, achalasia * Patients on oral anticoagulation including Coumadin, and warfarin, unless discontinued for five days prior to the sponge procedure * Patients on antiplatelet agents including clopidogrel, unless discontinued for five days prior to the sponge procedure * Patients on oral thrombin inhibitors including dabigatran and oral factor X an inhibitor such as rivaroxaban, apixaban, and edoxaban, unless discontinued for five days prior to the sponge procedure * Patients with a history of known varices or cirrhosis * Patients with a history of esophageal or gastric resection * Patients with congenital or acquired bleeding diatheses * Patients with a history of esophageal squamous dysplasia