It was taking too long for patients of Seemal Awan, M.D., to get a procedure that checked their esophagus for a particular kind of white blood cell called the eosinophil that is a sign of eosinophilic eesophagitis (EoE).
“What happens is they have a cell that is not supposed to be in the esophagus, and it just wreaks havoc,” said Dr. Awan, the medical director of Meritus Allergy & Asthma Specialists.
The typical way to check for evidence of eosinophils is to have a gastroenterologist perform an upper endoscopy – inserting a thin tube with a camera down the throat – to look for inflammation and to take biopsies to check for eosinophilic esophagitis.
Patients would have to wait months or longer, sometimes, possibly even traveling out of the area. So, Dr. Awan sought a way to check for signs of the chronic immune system disease in the office on Diamond Drive in Hagerstown.
The federal Food and Drug Administration recently approved a procedure by EnteroTrack that fits the bill. EnteroTracker – what Dr. Awan and others call the “string test” – involves the patient swallowing a pill that has a string attached to it.
The pill goes into the stomach and slowly dissolves over an hour. Meanwhile, the string remains in the esophagus and is taped to the cheek.
Though there’s a little uncomfortable feeling at first for 2 to 3 minutes, drinking water helps get over the sensation. The patient then can sit and read or check their phone until it’s time to pull out the string, which is then sent to a lab for testing.
“It is generally well-tolerated,” Dr. Awan said of the procedure. “I do not recommend it to initially make the diagnosis of eosinophilic esophagitis, but it is helpful for checking the number of eosinophils to see if we need to adjust a patient’s medication or diet.”
The procedure was pioneered at Children’s Hospital of Colorado with the University of Colorado. Dr. Awan said she learned of the test at the annual allergy conference.
Aside from getting results quickly and treating her patients faster, Dr. Awan said that perhaps it is the simplicity of the test that makes it appealing.
“I think it’s pretty cool,” she said.
To learn more about Meritus Allergy & Asthma Specialists or to schedule an appointment, readers may visit www.meritushealth.com/Allergy.
