Diagnostic Procedures for Esophageal Conditions
If you have digestive problems, the esophagus may be involved and needs to be tested to determine the cause.
Your esophagus is the "food pipe" that connects your throat to your stomach. Because it moves food and liquid down to the stomach, it's a vital part of the digestive process.
UC San Diego Health leads the field in esophageal testing and has pioneered several of the diagnostic approaches below.
Esophageal manometry is a procedure that measures the strength and function of the muscles in your esophagus that work to push food and liquids from the mouth down to the stomach.
This test is used to evaluate the cause of problems with swallowing food, such as food or liquids getting stuck in the chest after swallowing; the cause of reflux of stomach acid and contents back into the esophagus (gastroesophageal reflux disease or GERD); and chest pain that may be coming from the esophagus rather than the heart.
A thin, flexible tube containing many sensors will be passed through your nostril, down the back of your throat and into your esophagus. We will take measurements as you swallow a spoonful of water.
Our team of experts at UC San Diego Health pioneered the current protocol and classification scheme for esophageal manometry and uses state-of-the-art high-resolution impedance manometry systems.
Esophageal pH Monitoring
Esophageal pH monitoring determines how much and how often stomach acid enters the esophagus and how long it stays.
Two procedures are used to test acidity, or pH, in the esophagus. These tests can help us:
- Pinpoint treatment options if you have GERD and are not responding to medications
- Identify conditions such as nonacid reflux and low acid reflux disease
In the catheter-based approach, a thin tube is inserted through the nose down to the stomach to measure acidity in the esophagus. This is also called pH combined with impedance.
In the wireless Bravo approach, a tiny sensor is placed endoscopically in the esophagus.
Both of these approaches are measurement tools to record and track liquids splashing upward into your esophagus. This may be causing heartburn and esophageal pain.
A functional lumen imaging probe (FLIP) is used to evaluate the function of the esophagus by measuring its dimensions using impedance planimetry technology. It is typically performed during endoscopy and can identify the cause of problems with swallowing food, including esophageal motility disorders such as achalasia.
We are experts in FLIP technology and our center is among just a few in the United States to offer FLIP testing.
Endoscopic ultrasound is a special endoscope using high-frequency sound waves to produce detailed images of the lining and walls of the digestive tract. It is used to assess the thickness of the muscle that lines your digestive tract. It can also detect cancer or pre-cancerous lesions.
Upper GI endoscopy is a procedure to see inside your esophagus, stomach, and the beginning part of the small intestine (duodenum). The endoscope is a tube with a special type of camera that sends high-definition pictures of the lining of your gastrointestinal tract to a video screen.
Wide area trans-epithelial sampling using artificial intelligence and 3D imaging technology is a new method to detect Barrett's esophagus. It can identify pre-cancerous cells and is performed during an upper endoscopy by brushing the diseased tissue.