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Gastrointestinal Disorders

Testing and Diagnostic Technology for Upper GI Disorders

Esophageal Manometry

Determination of how the esophagus and sphincters (valves) work by measuring the pressure generated by the esophagus muscle and sphincters.

Esophageal pH Testing

A wired or wireless device can be used to record acid reflux in patients not taking antacids. In the first method, a very thin tube with a pH electrode attached to its tip is passed 5 cm above the lower esophageal sphincter (valve) and the number of times and duration of acid reflux is measured for 24 hours to 48 hours. The other method utilizes the endoscopic placement of a tiny wireless electrode 6 cm above the sphincter with monitoring for 48 hours. This is a standard method to identify patients with reflux that needs treatment, and also differentiate reflux from other causes of similar symptoms.

Barium Swallow X-ray (Esophagram)

Barium that shows up on x-ray (fluoroscopy) is swallowed and followed through the esophagus, stomach and into the small intestine. This test is done for people who have trouble swallowing, or with stomach pain or heartburn. The test can find inflammation, motility disorders, strictures and stenosis, ulcers and malabsorption.

Esophagogastroduodenoscopy (EGD) which is endoscopy of esophagus, stomach and upper small intestine and may include biopsy of abnormalities.
In this minimally invasive procedure a tube is inserted through the mouth to visualize the esophagus, stomach and upper small intestine. Usually sedation is used and the procedure lasts between 5 and 20 minutes. This test is performed to evaluate heartburn, GERD, difficulty swallowing, painful swallowing or chronic nausea.  EGD is also used to monitor patients with Barrett’s esophagus, gastric or duodenal ulcer or as a follow-up to surgery on the esophagus or stomach.

Esophageal Dilatation

This is usually done in combination with an EGD. In this procedure esophageal strictures or rings are dilated in order to restore normal swallowing. The dilatations are done either over a guide wire utilizing a polyvinyl tube in graduated sizes, or by inflating special balloons in graduated sizes. In some cases fluoroscopic guidance is used.

Gastric Emptying Time

This test measures the speed with which consumed food leaves the stomach and enters the small intestine. In this test a small (and safe) radioactive food is eaten and then a scan like a Geiger counter is placed over the abdomen.  With normal gastric emptying the test last less than 90 minutes. With delayed emptying condition it could take up to 6 hours or more to have the food leave the stomach. This test is performed for patients with upper abdominal pain or bloating and is often performed in patients with GERD to make sure the stomach empties.   

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