The Esophageal String Test is a brand-new option, and USF Health is one of only three sites in the country offering it.
Racha Khalaf, MD, assistant professor and chief of Pediatric Gastroenterology at the USF Health Morsani College of Medicine, is using a less invasive method to monitor a condition known as Eosinophilic Esophagitis (EoE). The chronic disease is characterized by white blood cells called eosinophils infiltrating the esophagus and causing inflammation, which can lead to difficulty swallowing or food getting caught in the swallowing tube known as the esophagus.
Esophageal String Test with capsule.
鈥淓oE patients have a migration of eosinophils to the esophagus, causing symptoms like vomiting and difficulty eating,鈥� Dr. Khalaf said. 鈥淚n children, it can even lead to difficulty with growth.鈥�
Traditionally, after diagnosing the condition, physicians monitor EoE using a sedated procedure known as an endoscopy, in which the doctor snakes a tube containing a tiny camera down the patient鈥檚 throat to view the esophageal lining. The procedure requires anesthesia in children and can have risks including pain and discomfort. But Dr. Khalaf said she uses the Esophageal String Test, which provides her the information she needs to determine a treatment plan without the same level of discomfort and an improved risk profile.
The Esophageal String Test is a brand-new option, and USF Health is one of only three sites in the country offering it.
Dr. Racha Khalaf.
During the test, the patient swallows a small pill containing a flexible string. The end of the string is taped to the cheek and the string remains in place for one hour and collects esophageal secretions that are then examined for the presence of inflammation caused by eosinophils.
For 9-year-old Shark Smith, who has been diagnosed with EoE, the Esophageal String Test is a welcome alternative to regular endoscopies. 鈥淚t鈥檚 better because I don鈥檛 have to get put under with anesthesia,鈥� he said. 鈥淎nd it doesn鈥檛 take that long. It only takes an hour.鈥�
Shark鈥檚 mother, Jennifer Smith, shared his sentiment. She said, 鈥淗e鈥檚 been scoped, I think, seven times since he was two years old.鈥� The diagnosis of EoE came accidentally when Shark swallowed a penny, leading to his first endoscopy. 鈥淲e never had any symptoms,鈥� she said.
The Esophageal String Test proved beneficial when Shark鈥檚 treatment was not yielding the desired results. 鈥淚t told us that we鈥檙e pretty much taking this medication for no reason now,鈥� Jennifer Smith said. 鈥淪o, we have to change our treatment plan.鈥� They came to Dr. Khalaf, seeking other options apart from scoping every six to 12 months.
鈥淚t鈥檚 easier on him; it鈥檚 easier on the mom,鈥� Jennifer Smith noted. Shark recommends patients bring something to keep themselves entertained during the procedure, such as a book or an electronic device. Both mother and son praise Dr. Khalaf and the string test. 鈥淒r. Khalaf is amazing,鈥� Shark said. 鈥淎nd if anybody has the chance to do this, I would definitely recommend it over scoping.鈥�
鈥淲e鈥檙e just really happy,鈥� Jennifer Smith said. 鈥淲e鈥檙e happy with Dr. Khalaf. We鈥檙e happy with the test.鈥�
Story, video and images by Allison Long, USF Health Office of Communications.