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. Doctors usually order these tests to evaluate conditions such as gastroesophageal reflux disease (GERD), esophageal motility disorders/difficulty swallowing, achalasia, and hiatal hernias.

Here are some of the esophageal function tests UAB Medicine offers:

High-resolution esophageal manometry

Doctors or nurses place a thin, pressure-sensitive tube 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. It is also commonly done prior to anti-reflux surgery.

pH monitoring

Doctors or nurses insert a thin tube into the esophagus, and it remains in place for 24 hours to monitor stomach acid in the esophagus. 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 doctor temporarily implants a wireless monitoring device (the Bravo device) into the esophagus to measure any 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 and wirelessly transmits it to a recording device worn by the patient during the testing period.

Impedance testing

Nurses insert a thin tube into the esophagus so that doctors can measure gas or liquids that may cause reflux or are entering the esophagus. This test helps them assess regurgitation or reflux of non-acidic substances. It is often performed along with pH monitoring.

Functional luminal impedance planimetry (FLIP)

Doctors use The FLIP test during an endoscopy to measure the distensibility (swelling/stiffness) of the esophagus. Doctors consider results from FLIP alongside results of a high-resolution esophageal manometry test to screen for unknown motility (movement) disorders. Such disorders may occur in patients who have trouble swallowing.

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