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Minimally Invasive Monitoring: The Esophageal String Test

In a remarkable leap forward for pediatric healthcare, physician-researchers at Phoenix Children’s Hospital have introduced the esophageal string test (EST), a minimally invasive tool designed to revolutionize how eosinophilic esophagitis (EoE) is monitored in children. EoE is a chronic inflammatory disease that can make swallowing challenging and painful. Traditionally, diagnosing and monitoring this condition involved repeated and uncomfortable procedures like endoscopies under sedation. In contrast, the EST presents a sedation-free alternative, significantly improving the patient experience.

Dr. Shauna Schroeder, co-medical director of the hospital's Eosinophilic Gastrointestinal Disease Clinic, explains that the EST allows for monitoring of EoE in a much less invasive way. “This approach spares children the discomfort of repeated endoscopies under anesthesia, enabling us to assess their condition in an outpatient setting,” she shares.

How Does the Esophageal String Test Work?

The EST is a simple concept that can have profound implications for the management of EoE. Patients ingest a tiny capsule containing a nylon string that collects esophageal secretions as it passes through the swallowing passage. This string gathers critical biomarkers, which provide insights into the state of inflammation in the esophagus. Unlike the traditional method, the EST does not require sedation, allowing patients to avoid extended absences from school or work.

To date, over 100 patients aged 6 to 22 have successfully participated in the ES testing at Phoenix Children’s, making this the largest real-world clinical evaluation of the EST for EoE. The results have been promising, with most children tolerating the test well and reporting only mild side effects, primarily sore throats. These findings have been detailed in The Journal of Allergy and Immunology In Practice, where Dr. Schroeder serves as lead author.

Streamlining Patient Experience

Dr. Cindy Bauer, co-author of the study and chief of allergy and immunology at the clinic, highlights that the EST represents a significant opportunity to rethink the management of chronic esophageal diseases. She remarks, “The ability to provide real-time, non-invasive monitoring opens doors for better disease management and improved outcomes.”

The introduction of this innovative tool aligns perfectly with Phoenix Children’s commitment to enhancing the quality of life for its patients. By providing an accessible option for esophageal testing, the EST minimizes the disruptions in patients’ everyday lives while still delivering essential data for optimized care.

“Families now have a more convenient option for esophageal evaluations,” emphasizes Dr. Benjamin Wright, a pediatric allergist and immunologist at Phoenix Children’s. He stresses the importance of reducing the burden on families while ensuring they receive the necessary medical monitoring.

Future Implications

As Phoenix Children’s continues to enhance its healthcare mission through research, education, and innovation, the introduction of the esophageal string test stands as a testament to what can be achieved through a patient-centered approach. The ability to conduct these tests without sedation not only eases the physical and emotional burden on children but also represents a leap toward more modern, effective healthcare solutions.

For more information on the Eosinophilic Gastrointestinal Disease (EGID) Clinic and its pioneering efforts, visit phoenixchildrens.org. With ongoing advancements like the EST, Phoenix Children’s Hospital exemplifies its mission to elevate pediatric care and improve health outcomes for children across Arizona and beyond.