Esophageal Function Testing

UAB Medicine offers a full range of testing on the function of the esophagus, the tube that connects the throat to the stomach. These tests usually are ordered to evaluate conditions such as gastroesophageal reflux disease (GERD), esophageal motility disorders/difficulty swallowing, achalasia, and hiatal hernias.

Some of the esophageal function tests offered at UAB Medicine are described below:

High-resolution esophageal manometry: A thin, pressure-sensitive tube is passed into the esophagus to determine if it is contracting and relaxing properly. This test is mainly used to diagnose swallowing disorders such as achalasia and esophageal spasms, and it is often done prior to anti-reflux surgery.

pH monitoring: A thin tube is inserted into the esophagus, and it remains in place for 24 hours to monitor how and when stomach acid enters the esophagus and what the acid level is. Patients keep a food diary during the 24-hour test, which allows the physician to determine if symptoms are connected to acid reflux. This test also may help determine whether breathing symptoms are caused by reflux.

Bravo monitoring: A wireless monitoring device is temporarily implanted into the esophagus to measure any and all acid reflux that occurs during the 48- to 96-hour testing period. The Bravo device is placed during an upper endoscopy, or EGD, while the patient is sedated. The device collects information that is wirelessly transmitted and stored on a recording device worn by the patient during the testing period.

Impedance testing: A thin tube is inserted into the esophagus to measure gas or liquids that may cause reflux or are entering the esophagus. It helps assess regurgitation or reflux of non-acidic substances. This test is often performed along with pH monitoring.

Functional luminal impedance planimetry (FLIP): The FLIP test is used during an endoscopy to measure the distensibility (swelling/stiffness) of the esophagus. The information collected is combined with the results of a high-resolution esophageal manometry test and is used to screen for unknown motility (movement) disorders of the esophagus in patients who have trouble swallowing.