Unsedated transnasal endoscopy may be a feasible, safe and well-tolerated method to screen for esophageal disease in a primary care population, according to an American Society of Gastrointestinal Endoscopy release.
The study assessed the feasibility, safety, acceptability, and yield of unsedated TNE in a primary care population. It was a multicenter, prospective, cross-sectional study conducted from 2009 to 2010 at two outpatient tertiary-care centers. The main outcome measurements included procedure yield, completeness of examination, procedure length, adverse events and complications, choking, gagging, pain or anxiety during the examination and overall tolerability.
A total of 426 participants enrolled in the study, and 422 (99 percent) completed the examination. Mean examination time was 3.7 minutes. There were no serious adverse events, and 12 participants (2.8 percent) reported minor complications. Participants reported minimal choking, gagging, pain or anxiety. Although examination was well-tolerated by most participants, some experienced excess mucus, chronic throat clearing, chest pain or chronic sore throat. Overall, 38 percent of participants had an esophageal finding that changed management.
While unsedated TNE was shown to be a safe and effective method to screen for esophageal disease, the authors acknowledged two endoscopists with extensive experience in TNE performed the examinations. Therefore, it is possible that patient tolerability would be lower with less experienced endoscopists.
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