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Environmental enteric dysfunction (EED) is a poorly understood condition of the small intestine prevalent in low and middle income countries. This disease is believed to cause nutrient malabsorption and poor oral vaccine uptake, resulting in arrested neurological development and growth stunting in children that persists as they grow into adulthood. Optical coherence tomography (OCT) imaging of the small intestine can potentially capture some of the microstructural changes, such as villous blunting, in the small gut that accompany EED, and hence could potentially improve the understanding of EED and help in determining and monitoring the effectiveness of EED interventions. Notably, EED must be studied and diagnosed in infants, aged 0-24 months as this is the only window in which interventional strategies can reverse the disease. In order to address this need, we propose a trans-nasal OCT imaging technique for imaging the small intestine that may be suitable for low-resource settings owing to its simplicity, ease of administration, and implementation in unsedated infants. To demonstrate the potential of transnasal OCT intestinal imaging, we have created a 10 Fr transnasal OCT imaging probe and have submitted an IRB application for a first-in-human study using this probe to image the adult small intestine. We anticipate that the results from this pilot study will justify the development of a transnasal OCT intestinal imaging device for infants.
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