One of the first children’s hospitals in the Midwest to offer unsedated transnasal esophagoscopy (TNE) to diagnose and monitor eosinophilic esophagitis (EoE), Riley Children’s Health is now using new TNE technology available for children and adolescents.
Designed specifically for the gastrointestinal tract, the single-use transnasal gastroscope provides enhanced visibility, enabling Riley gastroenterologists to complete the procedure safely and effectively in about 10 minutes.
“The fact that TNE can be performed without anesthesia, with no post-procedure recovery and minimal side effects is significant for patients, especially those with EoE who require frequent endoscopy,” said Paroma Bose, MD, pediatric gastroenterologist at Riley Children’s. “This new technology, which offers higher-resolution imaging, contributes even more by providing the same tools as routine sedated endoscopy, such as multidirectional steering, air, water and suction.”
In addition to monitoring EoE and other esophageal conditions, the new transnasal gastroscope allows specialists to see further into the GI tract, making it a potential tool for evaluating H. pylori infections and for surveilling ulcer treatment and other inflammatory GI conditions. With the scope’s advanced capabilities, Dr. Bose predicts it could also be used in the treatment of ulcers and celiac disease.
As some of the first specialists trained in pediatric TNE, Dr. Bose and Riley pediatric gastroenterologist Ryan T. Pitman, MD, MSC, have performed the procedure, first using a repurposed bronchoscope, since 2021. TNE is part of a comprehensive, multidisciplinary Eosinophilic Gastrointestinal Disease (EGID) Program at Riley Children’s. The program includes experts in pediatric gastroenterology, allergy and immunology, and nutrition who see patients during the same scheduled visit.
“We serve as a medical home for patients who benefit from cohesive continuity of care for all of the allergic conditions that relate to and affect EoE,” Dr. Bose explained. “If a patient needs allergy or specialized testing, we can do it during their visit; if they need medication that requires at-home injections, we can provide training through the clinic.”
Part of a Riley GI division that’s prolific in research, EoE specialists are engaged in clinical research to uncover and evaluate new treatments. Riley Children’s was involved in a clinical trial for the biologic medication dupilumab and is currently participating in trials for erosive esophagitis and gastroesophageal reflux disease. In ongoing clinical research, Dr. Bose is studying proton pump inhibitors, investigating the biochemical and genetic factors that play a role in EoE treatment response. She also collaborates with biomedical researchers at the Herman B Wells Center for Pediatric Research at Riley Children’s to devise novel therapies for EoE.
“I like that I can combine treating patients with research designed to find out why some treatments work for some children and others don’t,” Dr. Bose said. “Being a part of the research and discovery that paves the way for new treatments for our patients is very exciting.”
Gastroenterology, Hepatology and Nutrition at Riley Children’s Health
GI and hepatology specialists at Riley Children’s provide expert care for patients with IBD, liver disease, obesity, allergic eosinophilic GI disorders, motility disorders, cystic fibrosis, short bowel syndrome, aerodigestive disorders and nutritional disorders. Riley Children’s is home to leading multidisciplinary programs for many of these conditions.