In this brief review we discuss the potential reasons underlying and follow up of patients who have a positive non-endoscopic swallowable cell collection device+biomarker (such as TFF3) test but no evidence of Barrett’s esophagus on endoscopy. We discuss the potential role of careful examination of the gastroesophageal junction and targeted biopsies of any visible lesions, as well endoscopic follow up in 3-5 years in the absence of any alarm symptoms. Considerations of the use of new technologies such as wide area transepithelial sampling in this situation are also discussed.
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