Present status and problems of upper GI screening with transnasal esophagogastroduodenoscopy (EGD): results of questionnaires from 14 medical institutes

Abstract

A survey of transnasal EGD was conducted in the form of a questionnaire given to 14 medical institutes that made presentations at Workshop 24 “Present status and problems of upper GI screening with transnasal EGD” at the 2007 conference of JDDW in Kobe. The selection rate with and the number of examinations using transnasal EGD varied considerably among individual patients. Transnasal or transoral EGD was usually selected, according to the patient’s preference, but the issue should be discussed further in private clinics which employ ultrathin scopes only. Regarding the contents of the informed consent, the following points were frequently discussed with the patients: comfortable examination with less frequent induction of the gagging reflex, the possibility of nasal pain or epistaxis, and the possibility of insertion via the oral route if the nasal cavity is too narrow. On the other hand, the possibility of poor maneuverability during target biopsy was explained in a few cases. The methods of nasal anesthesia also varied among the individual patients. Efforts were made to reduce the total amount of anesthetic agent in some cases. As for the complications, the rate of epistaxis was almost completely compatible with the previous reports. However, careful attention should be paid to those few cases in which there are difficulties in withdrawing the scope or sinusitis-like symptoms appear the day after the examination. Further scientific investigation of transnasal EGD will be indispensable in the future, including follow-up studies of false-negative cases.