Table 1

Summary of inclusion and exclusion criteria for commencing a standalone outpatient transnasal service

Inclusion criteriaExclusion criteria

  1. Any patient ASA grade II or less who requires standard diagnostic gastroscopy (including 2-week wait patients)

  2. Barrett’s oesophagus short segment (<3 cm)

  3. Eosinophilic oesophagitis assessment and biopsies

  4. Gastric intestinal metaplasia surveillance

  5. Post-HALO radiofrequency ablation surveillance (>2 years from procedure)

  1. ASA grade III and IV

  2. Unable to stop aspirin/clopidogrel*

  3. Current use of DOAC*

  4. Check ulcer healing†

  5. Barrett’s oesophagus surveillance >3 cm

  6. Any intervention required/expected

  7. Helicobacter pylori culture

  8. Duodenal biopsies for coeliac assessment (type 1/2 refractory)

  9. Nasal surgery/fractures/septal deviation/recurrent epistaxis (unless cleared by ENT)

  10. 12 months following endoscopic eradication therapy for Barrett’s (either RFA or EMR)

  • *Continuing antiplatelet and anticoagulant therapy as per BSG/ESGE ‘low-risk procedure’ guidelines27 are relative indications for inclusion for performing TNE once training phase is complete.

  • †Check of gastric ulcer healing can also be considered for inclusion based on risk of needing endoscopic therapy.

  • ASA, American Society of Anaesthesiologists; BSG, British Society of Gastroenterology; DOAC, direct acting oral anticoagulants; EMR, endoscopic mucosal resection; ENT, otorhinolaryngology; ESGE, European Society of Gastrointestinal Endoscopy; RFA, radiofrequency ablation; TNE, transnasal endoscopy.