What is transnasal endoscopy (TNE)?
Transnasal endoscopy, or TNE, is a minimally invasive procedure used to examine the upper digestive tract — including the esophagus, stomach, and duodenum — for ulcers, inflammation, or other possible causes of discomfort.
Unlike traditional endoscopy, your child will be fully awake during a TNE. No anesthesia is required, and they can return to school or other normal activities the same day with no restrictions.
Who may need a transnasal endoscopy?
We may recommend a TNE if your child:
- Is at least 8 years old
- Has been diagnosed with eosinophilic gastrointestinal disorders (EGIDs), such as eosinophilic esophagitis
- Has gastroesophageal reflux disease (GERD), celiac disease, or related conditions
- Needs repeated endoscopies to monitor a condition
- Has difficulty or pain when swallowing
- Is vomiting frequently or vomiting blood
- Has frequent stomach pain
In some cases, a traditional endoscopy may be recommended if your child:
- Has abdominal pain
- Has heartburn
- Has trouble swallowing
Why choose transnasal endoscopy?
TNE is a less invasive alternative to traditional endoscopy because it does not require anesthesia. It’s often a good choice for children who are anxious about needles. Your child will stay awake and aware throughout the procedure, and the recovery post-procedure is quick — most children can return to their usual routine and activities the same day.
The TNE is done in the Gastrointestinal Procedure Unit (GPU). The procedure itself takes about five to 10 minutes. You should plan to be at the hospital for a total of one to two hours.
What are the risks?
While TNE is generally safe, possible side effects include:
- Mild nosebleed
- Sore throat
- Nasal discomfort
- Nausea or vomiting
How transnasal endoscopy got Jamie back on the golf course
When Jamie was having bouts of throwing up and getting food stuck in his throat, he and his mom knew it wasn’t just a case of a growing teen boy.
Preparing your child for a transnasal endoscopy (TNE)
To get the best results and to keep your child safe during a TNE, please:
- Do not give your child solid food for four hours before the procedure.
- They may have clear liquids like water or apple juice, but please stop all drinks two hours before the procedure.
- Do not give your child gum or candy on the day of the procedure.
What to expect at the hospital
When you arrive at the GPU, a nurse will check in with you and your child to make sure everything is ready. You’ll then meet with your child’s doctor, who will explain the procedure and answer any questions you may have.
During the procedure
In the exam room, your child will receive numbing medicine for their nose and throat. This helps them stay comfortable and reduces any sensation from the small tube used in the procedure.
To help your child relax, they’ll have the option to watch a movie or TV show using 3D virtual goggles during the procedure.
During the procedure, your child’s doctor will use an endoscope (a thin, flexible tube with a camera at the end of it) to look at their esophagus and stomach. The tube is inserted through one nostril, guided down the throat, esophagus, and into the stomach. It can be expected that your child might gag a little when the tube is inserted, but that is normal and will last only a few seconds.
The doctor will take small pieces of tissue from your child’s esophagus and send it to be reviewed in our lab under a microscope. Once they retrieve their samples, the tube is gently removed, and the test is over.
For more information about what to expect during the TNE, please refer to our family education sheet.
What to expect after a TNE
Your child will stay in the room for a short time after a TNE for observation. Your child’s doctor will talk to you about what they saw during the test and may show you pictures they captured. We’ll give your child a popsicle while we review these results.
Your child will be able to eat and drink shortly after the procedure, beginning with clear, cool liquids. If they start to cough when they try to eat, wait 30 minutes and try again. We also recommend that they do not drink any red liquids or eat salty or spicy foods until the next day.
Contact us
Please call 617-355-6369 and ask for the GI fellow on call if you notice your child has:
- A fever of 101 degrees Fahrenheit or higher
- A lot of pain
- Signs of bleeding
- Vomiting
Please call us if you can’t follow the pre-procedure guidelines as instructed: 617-355-6172, option 3 (7 a.m. to 4 p.m. weekdays).
For procedure arrival times, call 617-355-6172, option 1, from noon to 4 p.m. the day before the procedure.
For questions after regular business hours, call the Boston Children’s Hospital page operator at 617-355-6369 and ask for the GI fellow on call.
