Transnasal esophagogastroscopy (also called transnasal esophagogastroduodenoscopy or TNE) is a modern, patient-friendly alternative to conventional oral endoscopy of the esophagus, stomach and duodenum. Instead of inserting the endoscope through the mouth and throat (which requires deep sedation or general anesthesia in most cases), the ultra-thin endoscope (approximately 5.9 mm in diameter) is gently introduced through the nose under local anaesthesia. This eliminates the gag reflex almost completely, avoids the need for intravenous sedation in the vast majority of patients, and allows you to remain fully awake, comfortable and able to speak during the entire examination.

The procedure provides the same high-quality diagnostic images of the esophagus, stomach and duodenum as the traditional method, including the possibility of taking biopsies, performing therapeutic interventions (e.g., dilation of strictures, removal of small polyps, hemostasis), and screening for Barrett’s esophagus, reflux disease, eosinophilic esophagitis, gastric ulcers, celiac disease, Helicobacter pylori infection or early cancer detection.

Why choose transnasal esophagogastroscopy (TNE)?

• No sedation or anesthesia required in >95% of patients → you can drive yourself home immediately after the procedure and resume normal activities the same day.
• Virtually no gag reflex or discomfort during the examination.
• Lower cardiovascular stress (ideal for elderly patients or those with heart/lung conditions).
• Significantly lower risk of complications compared to sedated oral endoscopy.
• Real-time communication with the doctor during the procedure – you can watch the screen and ask questions.
• Quick recovery: most patients describe it as “easier than a dental check-up”.
• Same diagnostic and therapeutic accuracy as conventional endoscopy.

Where do you provide this and who are my doctors?

At Clinica Omega Zeta in Andorra. TNE is performed jointly by our highly experienced otorhinolaryngologist–head and neck surgeon Dr Wreesmann and our gastroenterologist Dr Guirola. The transnasal route is prepared and managed by the ENT specialist (topical anesthesia and decongestion of the nasal cavity), guaranteeing maximal patient comfort and safety of the nasal passage, while the gastroenterologist performs the complete esophageal, gastric and duodenal examination. This interdisciplinary collaboration combines the best nasal expertise with cutting-edge gastroenterological knowledge, making the procedure exceptionally smooth and pleasant.

Our philosophy:

We believe that diagnostic procedures should not cause more discomfort than the condition itself. We therefore invest extra time before the examination to explain every step, answer all questions, and ensure optimal nasal preparation. Patients regularly tell us that their initial anxiety completely disappeared once the examination started. If, for whatever reason, transnasal access proves difficult, we can immediately and safely switch to the conventional oral route under light sedation – but this is required in fewer than 3–4% of cases.

Who is this for?

• Patients with fear of conventional endoscopy or previous unpleasant experiences.
• Anyone who wants to avoid sedation and be able to drive home immediately.
• Elderly patients or those with significant comorbidities (heart disease, lung disease, etc.).
• Patients needing regular surveillance (Barrett’s esophagus, varices, post-bariatric surgery, etc.).
• Professional drivers, pilots, cyclists, or anyone who cannot afford downtime.
• Patients seeking the highest comfort level without compromising diagnostic quality.

Advantages of Clinica Omega Zeta Andorra as your TNE destination

• Latest-generation ultra-slim endoscopes (5.9 mm) with exceptional image quality.
• Performed in a calm, private, state-of-the-art facility in the heart of the Pyrenees.
• Unique interdisciplinary ENT–gastroenterology team approach.
• No waiting lists – appointments usually within days
• English, Spanish, French, Catalan and German spoken fluently.
• Absolute discretion and personalized care in the tranquil microstate of Andorra.