Digestive Experts Advance Care with New Technologies

At the intersection of clinical care and research innovation, the Digestive Health Institute at Children’s Hospital Colorado is redefining how digestive diseases are diagnosed and managed. By developing and implementing advanced technologies, our gastroenterology specialists offer innovative tests and treatments not widely available at other hospitals. And it all starts with visionary leadership and a commitment to transforming patient care.

String test tests theory at Children’s Colorado 

Dr. Glenn Furuta, MD, Director of the Digestive Health Institute, is a national leader in treating eosinophilic esophagitis (EoE). And in 2007, he had an idea for a minimally invasive EoE test using a capsule attached to a string. The idea came from a test developed in the 1970s to check for intestinal parasites. Could this test be altered to identify the presence of unique proteins associated with eosinophils in patients with EoE? A dedicated team of researchers tested the theory. In a side-by-side comparison, the results of the string test were consistent with an endoscopy. After over a decade of testing and clinical trials, the string test became available for patients in 2022.

Since its implementation at Children’s Colorado, over 40 allergy practices and 9 gastrointestinal practices across the country use the string test for the surveillance of EoE. For families, it’s been life-changing.

“The string test allows us to assess EoE in a less invasive way and decreases the risk of anesthesia, time away from school, and ultimately, decreases the cost,” says Nathalie Nguyen, MD, pediatric gastroenterologist.

So far, Dr. Nguyen and the Digestive Health Institute team have completed 79 string tests.

Transnasal endoscopy reduces need for anesthesia during endoscopy 

The string test was only the beginning of the search for less invasive gastrointestinal tests at Children’s Colorado. A group of gastroenterologists, pulmonologists, otolaryngologists and members of the Aerodigestive Program, developed transnasal endoscopy (TNE) in pediatrics — a quicker, less invasive procedure than the traditional endoscopy.

Patients receive a numbing nose spray while a gastroenterologist gently slides a tiny camera through the nose into the esophagus to take pictures and tiny biopsies. It is similar to a traditional endoscopy but goes through the nose and there is no anesthesia. The procedure takes about five minutes, cutting recovery time and costs dramatically. A TNE costs around one-third the cost of sedated endoscopy.

Children’s Colorado leads the nation in performing this procedure with almost 2,000 total TNEs, or about 200 a year.

“While we primarily do it for the surveillance of assessment of EoE, it can be used in other diagnoses,” says Dr. Nguyen. “We’ve shown a decrease in cost, decrease in adverse events and even decrease in time in clinic.” 

There are still limitations to every technology. For example, for now, TNE only goes to the esophagus. Over the last year, Dr. Nguyen and team have started doing transnasal esophagogastroduodenoscopy (TNEGD). This procedure goes farther than the esophagus through to the duodenum — the first part of the small intestine. Like all endoscopies, TNE and TNEGD provide the specialists with a snapshot of what is inside.

“With TNE, we can get biopsies of the esophagus just like we can with traditional endoscopy” says Dr. Nguyen.

IB-Stim treats abdominal pain associated with irritable bowel syndrome 

In addition to developing methods for diagnosing and monitoring diseases, Children’s Colorado offers unique and specialized treatments. Children’s Colorado is one of the few hospitals to offer IB-Stim treatment. IB-Stim is a non-surgical device placed on and around the ear. It sends electrical pulses through nerve bundles of the ear to impact areas of the brain that process pain. IB-Stim is a treatment for functional abdominal pain associated with irritable bowel syndrome and functional dyspepsia approved by the U.S. Food and Drug Administration for patients aged 8 to 21 years. 

The device is placed by specially trained medical providers and delivers pulses for five days at a time, after which it can be removed. The patient returns weekly to have the device placed again. This cycle repeats for four weeks. 

“Most patients will see at least a 30% improvement in their worst pain,” says Alexandra Kilgore, MD, pediatric gastroenterologist. “We would still encourage ongoing support with a gastrointestinal psychologist with the theory that it will allow for sustained improvement.” 

Since 2024, the team has placed over 100 devices on 37 patients. And over time, they expect to see the indication for the device expand to more pediatric gastroenterology conditions.

These innovations and advancements in care come from listening closely to the concerns of patients in our multidisciplinary clinic. From developing the string test and TNE to implementing technologies like IB-Stim, the Digestive Health Institute is leading the way in offering cutting-edge treatment and testing options.