43197 Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

Name of the Procedure:

Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure).

Summary

Esophagoscopy is a diagnostic procedure that involves using a flexible tube with a camera (endoscope) to examine the esophagus through the nose. This version of the procedure may also involve collecting tissue samples via brushing or washing for further analysis.

Purpose

Medical Condition or Problem:

Esophagoscopy is used to investigate symptoms such as difficulty swallowing, unexplained chest pain, persistent heartburn, or other abnormalities in the esophagus.

Goals or Expected Outcomes:

The goal is to diagnose conditions like inflammation, strictures, tumors, or gastroesophageal reflux disease (GERD) and to collect specimens for laboratory testing if needed.

Indications

• Persistent or worsening symptoms of GERD
• Unexplained chest pain
• Difficulty swallowing (dysphagia)
• Suspicion of esophageal cancer
• Evaluation of known esophageal conditions
• Persistent symptoms despite treatment

Preparation

• Fasting for at least 6-8 hours before the procedure.
• Adjusting certain medications as directed by the healthcare provider.
• Undergoing pre-procedure diagnostic tests such as blood work or imaging if required.

Procedure Description

1. The patient is seated upright and given a topical anesthetic to numb the nasal passages and throat.
2. A flexible endoscope is gently inserted through one nostril and guided down the esophagus.
3. The camera on the endoscope transmits images to a monitor, allowing the doctor to examine the esophageal lining.
4. If necessary, the doctor collects cell samples using a small brush or by washing the esophagus with a fluid that is then collected for analysis.
5. The endoscope is carefully withdrawn, and the patient is monitored for a short period.

Duration

The procedure usually takes about 10-30 minutes.

Setting

Typically performed in an outpatient clinic or hospital endoscopy unit.

Personnel

• Gastroenterologist or trained endoscopist
• Registered nurse or endoscopy technician
• Possibly an anesthesiologist if deeper sedation is required

Risks and Complications

• Mild discomfort or nasal irritation
• Sore throat
• Bleeding, especially if biopsies are taken
• Rare risk of nasal or esophageal injury
• Infection
• Reaction to anesthesia (if used)

Benefits

The procedure allows for a thorough examination of the esophagus and can help diagnose specific conditions. Specimen collection can provide essential information for further treatment. Benefits are typically realized shortly after the procedure when results guide treatment plans.

Recovery

• The patient can usually go home shortly after the procedure.
• Mild throat discomfort or nasal irritation may persist for a day or so.
• Follow any dietary or activity restrictions advised by the doctor.
• Attend follow-up appointments as scheduled.

Alternatives

• Barium swallow X-ray: Less invasive but less detailed.
• Capsule endoscopy: Swallowed camera capsule, but no tissue samples can be taken.
• Traditional esophagoscopy: More invasive and usually requires sedation.

Patient Experience

• Patients may feel some pressure or discomfort during the insertion of the endoscope but should not experience pain due to the numbing medication.
• Post-procedure, patients might have mild sore throat and nasal irritation.
• Over-the-counter pain relief and following post-procedure care instructions help manage discomfort and speed recovery.