Name of the Procedure:

Esophagoscopy, Flexible, Transnasal; with Biopsy, Single or Multiple

Summary

An esophagoscopy is a medical procedure where a flexible scope is inserted through the nose and down the esophagus to look for abnormalities. During this procedure, one or more biopsies (tissue samples) may be taken for further examination.

Purpose

The procedure is used to diagnose conditions affecting the esophagus, such as inflammation, infection, or cancer. It aims to provide a clear view of the esophagus and obtain tissue samples for diagnostic analysis.

Indications

• Persistent heartburn or acid reflux
• Difficulty swallowing (dysphagia)
• Unexplained chest or upper abdominal pain
• Suspected esophageal cancer
• Evaluation of known esophageal conditions
• Unexplained weight loss

Preparation

• Patients may be asked to fast for 6-8 hours before the procedure.
• Inform your doctor about any medications you are taking; you may need to adjust or stop certain medications.
• Routine blood tests and imaging studies may be required prior to the procedure to assess overall health.

Procedure Description

1. The patient is seated in an exam chair.
2. Local anesthetic is applied to numb the nasal passages.
3. A thin, flexible endoscope is inserted through one nostril and gently guided down the esophagus.
4. The doctor inspects the esophagus lining and takes one or more biopsies using small tools passed through the endoscope.
5. The scope is carefully removed once the examination and biopsies are complete.

Tools and Technology:

• Flexible endoscope
• Biopsy forceps
• Local anesthetic (spray or gel)

Anesthesia:

• Local anesthesia to numb the nasal passages; sedation is generally not required.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or a hospital's endoscopy suite.

Personnel

• Gastroenterologist (or specially trained healthcare provider)
• Nurse or medical assistant

Risks and Complications

• Mild discomfort or nasal irritation
• Nosebleeds
• Gagging or nausea
• Rarely, perforation of the esophagus
• Infection
• Bleeding at the biopsy site

Benefits

• Provides a direct view of the esophagus for accurate diagnosis.
• Can obtain tissue samples without more invasive procedures.
• Quick recovery with minimal downtime.

Recovery

• Patients may experience mild throat or nasal discomfort for a few hours.
• Normal diet and activities can typically resume shortly after the procedure.
• Follow-up appointment may be scheduled to discuss biopsy results.

Alternatives

• Barium swallow X-ray: less invasive but does not allow for biopsies.
• CT or MRI scans: can provide detailed images but do not offer direct visualization or biopsy.
• Endoscopic ultrasound: another diagnostic tool that can image deeper layers of the esophagus.

Patient Experience

Patients may feel some pressure and discomfort but should not experience significant pain. Post-procedure, slight nasal congestion or throat soreness may be present but is generally mild and short-lived.