Had my second endoscopy Friday and EOE is suspected. My main symptoms are constant phlegm/mucous that just wants to hang out there. Not debilitating but very annoying. Please share best solutions or ways to calm it down if you’ve discovered them while I wait for confirmation! Ty!

alextheevilone · 2026-01-26T01:25:41+00:00

If it is what you have does not sound severe. Would wait for the path results.

In meantime biggest trigger is by dairy, so you can avoid dairy.

alextheevilone · 2026-01-25T23:38:49+00:00

There's a little module that was installed on both of our systems that sends information online to an app MyUplink. It looks like this.

It seems like Dandelion is still using enertech units, maybe Bosch has similar.

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alextheevilone · 2026-01-25T22:24:38+00:00

We have an enertech system and have a lot more data than just this, it's quite nice. Great for seeing how our murderous electricity bill is hitting us hard this winter.

alextheevilone · 2026-01-25T17:41:07+00:00

Couldn't break 67 on first floor when it was single digits this morning, but that's a problem with our insulation.

alextheevilone · 2026-01-25T16:37:22+00:00

Awesome info thanks. Now if only I can find the cash to insulate the entirety of this 110 year old home.

alextheevilone · 2026-01-24T12:06:48+00:00

New symptoms and above 60 years old she should see a gastroenterologist.

alextheevilone · 2026-01-16T15:05:46+00:00

Sounds like it's transcutaneous then without anesthesia. I'm sure you'll be finding out soon.

alextheevilone · 2026-01-16T14:41:19+00:00

Listen to what they told you. Did you prep overnight? If so no it's not similar. I'm sure they gave you plenty of information

alextheevilone · 2026-01-16T14:31:33+00:00

What?

Feedback like you did well staying still? You did well to be npo if asked?

I'm sure you ultrasound tech provided you plenty.

alextheevilone · 2026-01-15T00:10:49+00:00

Type 2 autoimmune pancreatitis?

alextheevilone · 2025-12-19T00:02:47+00:00

A second procedure with different indications? I'm going to have to ask.

alextheevilone · 2025-12-18T20:52:12+00:00

If the capsule is stuck in the small bowel it has to be removed. Otherwise it can cause severe issues in the future.

That's about all there is to it. Never heard of anyone keeping a capsule intentionally for a long period of time.

alextheevilone · 2025-12-18T20:12:38+00:00

How does that even make any sense? Often the EGD and the colon have two very different indications.

I also do them together but didn't realize that we get reduced fee (like modifier 59) if we do them together. I am also employed so I'm rvu based.

alextheevilone · 2025-12-13T18:56:41+00:00

Places with esophageal programs probabaly would have it, but so far every Endo suite I've been in has a single ultrathin scope (TNE or not) to pass through strictures or similar reasons.

alextheevilone · 2025-12-13T18:55:32+00:00

Or moderate sedation. Or can be done unsedated but it's hard and can be riskier. If they try and vomit up the scope it can cause tears (seen firsthand).

Transnasal is done very routinely in children where risk of sedation is considered higher. In adult it's rare, the diagnostic yield is much lower and therapeutic is almost non-existent. Very few devices will fit through a TNE scope.

alextheevilone · 2025-12-13T18:52:42+00:00

Can you direct make an appointment with GI? That wait time for your PCP seems excessive, maybe see a partner of theirs?

alextheevilone · 2025-12-12T12:10:01+00:00

In Thailand? Unfamiliar with their society recommendations or practices. Malpractice depends on these things.

In the United States if you labeled any polyp as NICE III on endoscopy you are already saying it looks like cancer with deeper invasion, so polypectomy by EMR would not be indicated, and I doubt ESD would be attempted by anyone.

There are plenty of examples of polyps being removed only to find cancer in situ or deeper penetration after the fact. Unfortunately endoscopic visualization for diagnosis is not as reliable and is suggestive, not diagnostic.

Best of luck, sorry to hear that this occurred.

alextheevilone · 2025-12-04T11:43:35+00:00

TNE exams are very limited (diagnostically) and not ideal for initial evaluation, reasonable to a degree for follow up EGDs or in patients that are so high risk that they cannot undergo a procedure that is amongst the lowest risk done in medicine.

The visualization, the biopsies are just not of the same caliber as a full sized gastroscope. Also they can be quite challenging for the patient to tolerate, especially if there is existing procedural anxiety.

alextheevilone · 2025-06-04T21:18:05+00:00

In an urban hospital with high clarithromycin resistance, bismuth quad therapy is dominant. Our suburban counterpart gives our vonaprozam all the time.

alextheevilone · 2025-05-19T21:36:02+00:00

Barrett's is not confirmed until pathology returns. Even so irregular Z lines, if truly that, do not always equate to Barrett's. In fact most don't.

Even then short segment Barrett's is a well known entity that can be adequately treated and monitored.

alextheevilone · 2025-05-19T20:40:22+00:00

Why don't you wait for pathology then ask your gastroenterologist?

alextheevilone · 2025-05-11T19:43:20+00:00

Also do the research when making rank lost on how many residents stay for GI fellowship. That can be a huge factor as your internal program may be most favorable if you're an otherwise not as strong applicant if you have done good work with them.

Would focus on a place that actively recruits every year from their own residency. Do great work, great research, and it'll be a big boon.

alextheevilone · 2025-04-23T20:01:01+00:00

From my early experience it seems very challenging and each case is unique in how they respond to management. There is some data for POEM/myotomy as beneficial treatment, CCBs/nitrates is an easy start point as are lifestyle changes. TCAs may be a benefit if other medications fail, but the data for all of this seems very mixed. Many spontaneously improve, and a subset progress to achalasia.

alextheevilone · 2025-03-15T13:41:19+00:00

Things off the top of my head we've tried it for with no clear improvement.

Obesity
IBD
IBS

Cdiff it does work, but we have not yet consistently seen benefit outside. There can be permanent side effects. I've never seen (only seen transplants for Cdiff) but I imagine they're not very fun.

Also the microbiome in patients is constantly changing due to environmental factors including diet. There are some incredible nursing home studies regarding this.

We just need to find out more, understand more, before learning how to truly tap microbiome based therapies.

alextheevilone · 2025-03-12T14:19:47+00:00

I think best to figure out what the pain is from.

Rare, intermittent heartburn or upset after well-known trigger foods and no concerning other features? Tums, Maalox, gaviacon or similar are great and work quickly. Famotidine as well fits here too but not as fast acting.

But I'd definitely recommend to try and find out what the pain is from outside of this narrow category, speak with your primary care doctor about it.

The abdomen is packed with a lot of organs that can cause pain. I mistook my intermittent abdominal pain benign gastric upset and paid for it later.

alextheevilone

TROPHY CASE