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Unsedated transnasal endoscopy with ultrathin endoscope as a screening tool for research studies

Authors

  • Robert M. Siwiec MD,

    1. Medical College of Wisconsin, Division of Gastroenterology and Hepatology, VA Medical Center, Milwaukee, Wisconsin, U.S.A.
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  • Kulwinder Dua MD,

    1. Medical College of Wisconsin, Division of Gastroenterology and Hepatology, VA Medical Center, Milwaukee, Wisconsin, U.S.A.
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  • Sri Naveen Surapaneni MD,

    1. Medical College of Wisconsin, Division of Gastroenterology and Hepatology, VA Medical Center, Milwaukee, Wisconsin, U.S.A.
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  • Mohammed Hafeezullah MD,

    1. Medical College of Wisconsin, Division of Gastroenterology and Hepatology, VA Medical Center, Milwaukee, Wisconsin, U.S.A.
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  • Benson Massey MD,

    1. Medical College of Wisconsin, Division of Gastroenterology and Hepatology, VA Medical Center, Milwaukee, Wisconsin, U.S.A.
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  • Reza Shaker MD

    Corresponding author
    1. Medical College of Wisconsin, Division of Gastroenterology and Hepatology, VA Medical Center, Milwaukee, Wisconsin, U.S.A.
    • Professor of Medicine, Chief, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, U.S.A.
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  • This work was presented in part at the Digestive Disease Week 2009 and at the Eighteenth Annual Dysphagia Research Society Annual Meeting, San Diego, California, U.S.A., March 3–6, 2010.

  • This work is supported in part by NIH grants: 1P01DK068051-01A1 and 5RO1DK025731. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

Asymptomatic subjects volunteering for research studies are generally stratified as healthy based on a questionnaire, medical interviewing, and physical examination. The aim of this study was to evaluate the prevalence of upper gastrointestinal (GI) abnormalities in healthy asymptomatic volunteers using unsedated transnasal esophagogastroduodenoscopy (T-EGD) with an ultrathin endoscope as an additional screening tool.

Study Design:

A prospective study from one academic medical center with extensive experience in T-EGD.

Methods:

Consecutive 150 subjects volunteering for research studies were initially screened by using a gastroesophageal reflux disease (GERD) questionnaire, interviewing, and examination. Based on these, they were stratified as healthy asymptomatic volunteers or with GERD. Unsedated T-EGD was then performed by a faculty member who was blinded to the results of the initial assessment.

Results:

On initial assessment using GERD questionnaire, medical interviewing, and physical examination, of the total 150 consecutive research volunteers, 83 (average age 33 ± 16 years; 46 females, 37 males) subjects were healthy asymptomatic volunteers and 67 (average age 36 ± 15 years; 35 females, 32 males) had symptoms of GERD. On T-EGD, GI pathology was found in 15 of 83 (18%) healthy asymptomatic volunteers as compared to 24 of 67 (36%) stratified as having GERD (P < .01). The esophageal abnormalities found in healthy asymptomatic volunteers were esophagitis (13.3%), Barrett's esophagus (2.4%), hiatus hernia (2.4%), and gastritis (2.4%).

Conclusions:

A small but significant number of asymptomatic subjects have abnormal upper GI findings. Hence, transnasal unsedated endoscopy can be considered as a screening tool to stratify subjects as healthy, especially when considering them for research studies. Laryngoscope, 2012

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