BRIEF RESEARCH REPORT article
Front. Pediatr.
Sec. Pediatric Gastroenterology, Hepatology and Nutrition
Volume 13 - 2025 | doi: 10.3389/fped.2025.1581225
This article is part of the Research TopicPediatric Gastroenterology And Visualizing The Digestive TractView all 7 articles
Endoluminal functional lumen imaging probe: A new modality in the evaluation of esophageal disorders in children and preliminary use in Eosinophilic Esophagitis
Provisionally accepted
- Grossman School of Medicine, New York University, New York, New York, United States
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Abstract: Introduction: Evaluating pediatric esophageal motility and structural disorders such as eosinophilic esophagitis (EoE) remains challenging. Conventional modalities are limited in their ability to assess biomechanical properties of the gastrointestinal tract, such as luminal compliance and distensibility. The endoluminal functional lumen imaging probe (FLIP) is a minimally invasive technology that uses impedance planimetry to measure esophageal parameters. Recent studies have shown the utility of FLIP in quantifying esophageal remodeling and fibrostenotic severity. FLIP-derived esophageal distensibility index (DI) is a sensitive marker for subclinical fibrosis and rigidity, often identifying esophageal narrowing not apparent on endoscopy or by symptom assessment alone. We investigated the use of FLIP to capture early esophageal dysfunction in patients with EoE, especially those in clinical remission. Methods: Retrospective chart review of patients with EoE who underwent EndoFLIP at our institution. EndoFLIP 2.0 Impedance Planimetry System was used via standard protocol. Variables in patients with EoE were compared by unpaired t-test. Results: Ten patients fulfilled inclusion criteria and 70% of the cohort were in clinical remission. The average minimum diameter at the narrowest luminal point at the maximum fill volume was 11.3 mm ± 3.3. The average distensibility index was 3.1 mm2/mmHg ± 1.4. Discussion: EndoFLIP was able to detect esophageal dysfunction in pediatric patients with EoE as evidenced by an overall low distensibility index. This adjunctive tool appears particularly useful in asymptomatic patients with EoE in clinical and histologic remission, as it may detect residual esophageal dysfunction highlighting the importance of early detection and ongoing therapy.
Keywords: Eosinophilic Esophagitis, Esophageal motility, Distensibility Index, FLIP, Children
Received: 21 Feb 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Berson and Levine. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jenna Berson, jenna.berson@nyulangone.org
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