title: Ultrathin unsedated transnasal gastroscopy in monitoring eosinophilic esophagitis.
abstract: BACKGROUND
  Ultrathin unsedated transnasal gastroscopy (UTEG) has a number of advantages applicable to eosinophilic esophagitis (EoE) and has not been evaluated for this condition.
  
  
  OBJECTIVE
  The aim of the study is to determine the feasibility of UTEG in patients with EoE and the acceptability of histological specimens obtained at biopsy.
  
  
  METHODS
  All patients with a diagnosis of EoE presenting to the outpatients department of two hospitals (Box Hill Hospital and The Alfred Hospital, Melbourne Australia) were asked to participate in the study. UTEG was performed on consenting individuals. Feasibility was determined by the success of nasal intubaton, patient perception according to post procedural survey, and adequacy of esophageal biopsies was assessed.
  
  
  RESULTS
  Ninety-six consecutive patients with EoE were offered UTEG, and 24 agreed to participate in the study. Seventy-four UTEGs were performed over a period of 26 months (September 2012 to December 2014). Nineteen patients had repeat procedures. Successful nasal intubation occurred in 97% (72 of 74 procedures), and 21 of 24 (86%) described high satisfaction with the procedure and minimal discomfort, and would choose UTEG for future procedures. Mean duration was 5 min. Adverse events of epistaxis (three cases) and vomiting of liquid contents during the procedure (two cases) were recorded, cardiorespiratory parameters remaining normal in all patients. All completed procedures produced adequate histological samples.
  
  
  CONCLUSIONS
  In those who decide to undergo UTEG, it is a safe and well-tolerated procedure.
authors.affiliation: Monash University.|Eastern Health.|The Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Hamish
authors.initials: H
authors.lastname: Philpott
authors.affiliation: Monash University.|Eastern Health.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Nandurkar
authors.affiliation: Monash University.
authors.forename: Simon G
authors.initials: SG
authors.lastname: Royce
authors.affiliation: Monash University.|Eastern Health.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Gibson
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000295:instrumentation* / Q000379:methods*; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000473:pathology*; D004844:Epistaxis / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology; D010465:Perception; D014839:Vomiting / Q000209:etiology; D055815:Young Adult
keywords: biopsy; eosinophilic esophagitis; gastroscopy; transnasal