Transnasal Endoscopy (TNE) Denver

Purpose: Transnasal endoscopy (TNE) involves a visual evaluation of the back of the throat, the esophagus, and the upper part of the stomach with a small, flexible endoscope. This allows for both the diagnosis of certain disorders of the throat, esophagus, and upper stomach as well as visualization of anatomy from a surgical planning perspective.

Description: TNE is a newer kind of endoscopy that is performed in our office without sedation. After local anesthetic spray to the nasal passages, an ultra-thin endoscope (small tube with a camera on the end of it) is passed via the nose, rather than the mouth, through the esophagus and into the stomach. This allows Dr. Bell to evaluate the anatomy of the larynx, esophagus, lower esophageal sphincter, and the stomach. You may wear special glasses and watch the procedure as he explains your anatomy.

Advantages: Transnasal endoscopy allows real-time evaluation of your anatomy, with less distortion than with a conventional endoscopy. That is why surgeons prefer TNE, when possible, to conventional endoscopy. Because there is no sedation, Dr. Bell is able to discuss the TNE results and make recommendations with you right after the procedure, especially if other testing (motility and pH testing) has already been completed. It is more cost effective than conventional endoscopy.

Risks: TNE minimizes contact with the tongue, greatly reducing the tendency to gag. Gagging is why conventional endoscopy done through the mouth over the tongue requires sedation. Though some mild discomfort may occur, from our experience, over 90% of patients are able to tolerate the procedure. At times, transnasal endoscopy does not provide an adequate visualization of the esophagus or stomach so a conventional endoscopy may be needed (less than 5%). Biopsy or dilation generally require conventional endoscopy.

Alternatives: Sedated upper GI endoscopy (EGD) is an alternative for patients who are unable or unwilling to undergo unsedated TNE. Frequently we have an idea, based upon a patient’s ability to tolerate esophageal manometry, of that ability or willingness.

Planning & Considerations: Your stomach needs to be empty, so do not have anything to eat or drink 4 hours prior to the test. Because there is no sedation, you can drive and resume normal activities immediately afterwards. If you are prone to nosebleeds or are on Coumadin (warfarin), please let us know as soon as possible as we may consider alternative plans.