A small flexible camera tube is introduced via the mouth into the oesophagus usually under sedation. This closely examines the linings of the oesophagus, stomach and duodenum to check for damage, inflammation, ulcers or other conditions. Biopsies are usually taken to assess the tissues from these areas under a microscope.
These are very detailed investigations which give an accurate representation of how the oesophagus is working
High Resolutions Manometry (HRM)
High Resolutions Manometry (HRM) is the gold-standard for assessing the function of the oesophagus. A fine catheter is placed via the nose into the oesophagus and upper stomach with the help of some local anaesthetic. This catheter has sensors which can record the pressures throughout the oesophagus, and informs us as to how well the oesophagus is working during swallowing, and how effective the junction between the oesophagus and stomach is at controlling reflux.
24-hour pH / Impedence Tests
24-hour pH / Impedence tests are also carried out with a similar catheter, again placed into the oesophagus via the nose with the help of local anaesthetic. Following placement, you are allowed to go back to your normal activities and the device records the levels of acidity (pH) in the oesophagus just above its junction with the stomach over a 24-hour (or more) period. During this time, any symptoms experienced are recorded and compared to the levels of acidity measured in the oesophagus. You are normally required to stop taking (where possible) all your anti-acid medications prior to this investigation. The catheter also has sensors which can assess the oesophagus for episodes of non-acid reflux during the study period.
Wireless 48-96-hour pH study
This test, which is performed by via endoscopy a special probe (BravoTM) is inserted onto the oesophagus just above the junction. The advantage of this test is that it can record acid exposure levels for up to 96-hours and there is no catheter in place. The device sends signals to a small remote receiver so patient can feel no restrictions in there activities. The device automatically detaches itself and is passed naturally.
I would just like to say a huge thank you for the exceptional support I received from you. I’m happy to say I am eating normally again and am totally reflux free. Keep on doing the wonderful job you do.
Contrast swallow / mea
This is a simple but very useful investigation where some radio-opaque dye (contrast) is swallowed as a drink, and then X-rays are screened to observe how this goes down the oesophagus, into the stomach and beyond. This gives a nice picture and video of how effectively the oesophagus and stomach are functioning. It is particularly good at assessing for hiatus hernia and give a real-time impression of the dynamics of swallowing.
The final diagnosis of reflux disease is made on the clinical presentation (symptoms) in conjunction with the results of all these tests (investigations). Following this, a definitive plan can be made on the best treatment options (management).
Symptoms of other gastro-intestinal diseases can present in a similar fashion to reflux. Investigations such as abdominal ultrasound, computerised tomography (CT) or magnetic resonance imaging (MRI) may be recommended. You will be advised about this during your consultations.