Screening for Barrett’s esophagus: Coming to a van near you?!

New studies suggest that a screening method called “transnasal endoscopy” (TNE) has promise to become a more acceptable tool to detect Barrett’s esophagus (BE) than traditional esophagoscopy.

Just as its name suggests, during a transnasal endoscopy, a tool called an endoscope passes through the nose, whereas during a regular endoscopy, the tube passes through the mouth.

An endoscope is a small, ultra-thin, flexible tube with a camera on the end of it. It is used to view the back of the throat, esophagus and upper region of the stomach.

Unlike a regular endoscopy, TNE is performed without sedation and as stated in an article from Gastroenterology and Endoscopy News, although “patients who underwent sedated endoscopy reported less discomfort, unsedated TNE was generally well tolerated and approximately 80% of patients who underwent the procedure said they would be willing to do so again in the future.”

Not only is this already widespread method of endoscopy associated with shorter procedure times, it is portable! One study used a van (similar in size to a food truck), which was set up as a mobile research unit to examine the feasibility of screening with TNE.

New studies suggest that transnasal endoscopy could become more acceptable as a portable screening tool for Barrett’s esophagus.

Transnasal endoscopy could become more acceptable as a portable screening tool for Barrett’s esophagus.

So what’s behind the feasibility of this screening method? The answer: the development of smaller “screening” units which utilize disposable sheaths.

A sheath prevents contact between the endoscope and the patient. This does away with the need to sterilize the scope and increases the ability to “mobilize” the screening units.

So, will you find a “transnasal screening van” beside your favorite food truck? Although it would be quite convenient and possibly ironic if your heartburn is also triggered by your favorite food truck, the likelihood of routine TNE screenings isn’t very high.

GastroEndoNews.com also reported Joel Richter, MD, director of the Division of Digestive Diseases and Nutrition at the University of South Florida, in Tampa, as saying “most patients prefer to be put to sleep.” In addition, “Dr. Richter also noted that optimal biopsies, which are more consistently obtained with a conventional scope, are required for patients with BE.”

A second study, using the same data as the “portable TNE study”, concluded that “substantial rates of BE can be identified in patients with obesity whether or not they complain of symptoms of Gastroesophageal reflux (GERD)”

Nicholas R. Crews, MD, a fellow in Mayo’s Division of Gastroenterology and Hepatology state in the same article that these findings: “directly challenges the established [GERD]-based screening paradigm for BE and provides strong rationale for using central obesity in Caucasian males, with or without [GERD], as a criterion for screening.”

“Both new studies were presented by investigators at Mayo Clinic, in Rochester, Minn., at Digestive Disease Week 2014 (DDW). Prasad G. Iyer, MD, a consultant in the Barrett’s Esophagus Unit in the Division of Gastroenterology and Hepatology at Mayo, led the work.”

To read more of Gastroenterology and Endoscopy News’s article, please visit: Transnasal Endoscopy To Go?

Sources:

Gastronterology Endoscopy News
Surgone Forgut Institute
The Physicinas Clinic 
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