Office-Based Unsedated Ultrathin Esophagoscopy in a Primary Care Setting

Article Figures & Data

Table 1.

Unsedated Ultrathin Esophagoscopy Indications, Findings, and Clinical Management

	Number	Percent
* Unsedated ultrathin esophagoscopy (UUE) was not completed in 3 patients.
† Confirmed on subsequent esophagogastroduodenoscopy with biopsy.
‡ 3 patients could not tolerate UUE, Barrett’s esophagus was suspected in 3 patients, 2 patients had other pathologic findings requiring biopsy, eg, esophageal nodule and gastric polyp.
Indications (n = 56)
Heartburn	53	94.6
Dysphagia	7	12.5
Odynophagia	5	8.9
Chronic hoarseness	5	8.9
Globus sensation	3	5.4
Chest pain	2	3.6
More than 1 indication	16	28.5
Findings (n = 53)*
Hiatal hernia	37	69.8
Esophagitis	16	30.2
Reflux laryngitis	7	13.7
Gastritis	5	9.4
Barrett’s esophagus^†	3	5.7
Schatzki’s ring	1	1.9
More than 1 finding	22	41.5
Clinical management (n = 53)*
At least 1 change in clinical management	42	73.6
Medication added/deleted	35	66.0
Esophagogastroduodenoscopy requested^‡	8	9.4
Radiograph requested	3	5.7
Consultation requested	2	3.8

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The Article in Brief

Ultrathin esophagoscopy is a new technology that allows physicians to view the patient�s esophagus. Because endoscope is thinner and more flexible, patients can be examined without sedation. This study finds that it is feasible for a family physician to perform unsedated ultrathin esophasgoscopy (UUE) in the office setting. Patients were willing to undergo the procedure, and most (95%) tolerated it; 90.6% of patients did not require further endoscopy after UUE. UUE could help in the diagnosis of diseases, such as Barrett�s esophagus. Such diseases are increasingly common as more people suffer from heartburn caused by gastroesophageal reflux disease (GERD). Further studies are needed to determine the utility, safety, accuracy and cost-effectiveness of UUE in primary care.