Endoscopic Assessment of Esophageal Luminal Diameter

Imagine sitting down for dinner and a piece of your food becoming stuck in your food pipe (esophagus). Unfortunately, for many patients with an inflammatory condition known as eosinophilic esophagitis (EoE), this symptom occurs all too often. Dysphagia, or difficulty swallowing, is an ‘alarm symptom’ in gastroenterology, alerting physicians to initiate a work up to determine the cause. In the algorithm for the work up of dysphagia, the first step is to perform an upper endoscopy. The clinician uses visual assessment to evaluate for inflammation and narrowings (strictures) that can be treated. Prior data suggests that physicians may not catch some strictures using visual estimation alone. A missed stricture can lead to unnecessary additional testing and a delay of diagnosis for the patient. Additional novel technology known as the Functional Lumen Imaging Probe (FLIP) exists to assist in the measurement of esophageal diameter. Our study aims to prospectively study and compare how accurately physicians measure esophageal diameter as compared to FLIP in patients with EoE. Better understanding the accuracy of endoscopic assessment by both visual estimation and FLIP assessment will offer insight into which tools should be used in diagnostic and therapeutic treatment of esophageal disease.