Esophagoscopy Without Sedation (Trans-Nasal Esophagoscopy; Esophagus Exam Endoscopy)


It is possible to examine without any
sedation the lining of the esophagus which is the tube that goes from the
mouth down into the stomach. Usually performed if there is concern for reflux
or esophageal cancer, this exam is performed by passing a scope through the
nose after adequate topical anesthesia. Here the scope is passed gently and
slowly through the nose. Once the back is reached, it is guided down into the
throat. Here we can see the voice box at this
point. The patient is instructed to swallow water a few times and the scope
is then passed into the esophagus. The scope is gently threaded towards the
stomach while the lining is carefully examined for any abnormalities. Here we have reached the point just
behind the heart. Here we can see a clear border
separating the esophagus from the stomach. At this point the scope is gently
withdrawn. If any abnormalities were seen, biopsies
would have to be taken. As you can see, the patient is able to tolerate this
exam without too much discomfort. Patients who are not candidates for
awake esophagus copy include a nose that is too small for the scope to enter as
well as patients with a very strong gag reflex.

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