Esophageal

At UCLA, we offer a wide array of esophageal testing. Tests include high-resolution impedance esophageal manometry, pH testing (both wire-based and wireless), fiberoptic endoscopic evaluation of swallowing (FEES), in addition to imaging studies such as the modified barium swallow study and barium esophagram.

High-resolution esophageal manometry

The esophagus is a long, muscular tube that connects the throat to the stomach. It contracts with swallowing to push food from the throat to the stomach. Esophageal manometry is a test that evaluates how well the esophagus works by measuring pressures produced by esophageal muscle contraction in response to swallowing. It is used to evaluate swallowing problems not caused by mechanical obstruction of the esophagus, chest pain not related to the heart, for preoperative evaluation to make sure the esophagus functions well enough to do anti-reflux surgery, and to assure correct placement of an esophageal pH catheter.

The test is accomplished with a thin, flexible catheter that has up to 36 pressure sensors spaced at 1 cm intervals along its length. It is attached to a computer and video monitor that display and store pressure information coming from the sensors. The test is performed by specially trained and experienced motility nurses while you are awake, so that you can participate. After the nasal passage is numbed by an anesthetic gel, the catheter is passed into the nose and swallowed into the esophagus by drinking water. It is placed so pressure sensors are positioned down the back of the throat to the stomach. Esophageal function is evaluated by giving you small amounts of liquid, a jello-like material, and sometimes solid food to swallow. The catheter is removed at completion of the study, and the data are stored on a computer for analysis. The whole process takes about 30 minutes. Once this has been completed, you may drive yourself home and go about your usual activities. The test is interpreted by gastroenterologists who are experts in esophageal diseases.

Esophageal manometry is used to diagnose or evaluate: Achalasia, acid reflux/GERD, cricopharyngeal bar, esophageal spasm, dysphagia, jackhammer esophagus, hiatal hernia, chest pain, supragastric belching, rumination, scleroderma, pre-operative evaluations for lung transplant, and pre-operative evaluations for anti-reflux surgery.

Your physician might order one of the following: Download prep instructions

• Esophageal manometry
• Esophageal manometry with catheter placement during EGD
• Esophageal manometry and 24-hour pH off-acid suppression
• Esophageal manometry and 24-hour pH on-acid suppression
• Esophageal manometry and 48-hour pH off-acid suppression
• Esophageal manometry and 48-hour pH on-acid suppression
• Esophageal manometry and 24-hour pH-impedance off-acid suppression
• Esophageal manometry and 24-hour pH-impedance on-acid suppression

Wire-based esophageal pH testing

This is a catheter-based test that measures the amount of acid reflux from the stomach into the esophagus over a 24-hour time period. Several kinds of probes can be used. The dual channel probe measures acid reflux into the lower and upper esophagus. Another probe, called pH-Impedance catheter, can measure non-acid reflux in addition to acid reflux. Additionally, the test checks for symptom correlation with recorded acid reflux episodes.

The test is performed by specially trained and experienced motility nurses. The nurse will insert a very thin catheter with sensors into one of your nostrils. It is about the thickness of a cellphone charging cord. The catheter is passed into the nose and swallowed into the esophagus by drinking water.

The catheter is attached to a recording device that you will keep near you for the duration that your doctor has specified. Your doctor will also indicate if you need to continue medication for acid suppression or stay off of it for a week before the test.

You will be given instructions on how to record your symptoms during the test. At the end of the study the catheter is removed from your nose and the data are loaded on a computer for analysis. The test is interpreted by gastroenterologists who are experts in esophageal disorders.

Esophageal manometry is done beforehand to determine where to position the catheter in the esophagus. The manometry might be done the same day or in advance. If you are scheduled for a pH test, and you have not had an esophageal manometry before, please discuss this with your physician.

pH test is used to diagnose or evaluate: Acid reflux.

pH-Impedance test is used to diagnose or evaluate: Acid reflux, non-acid reflux, supragastric belching, and regurgitation.

Your physician may order one of the following tests. Download prep instructions

• 24-hour pH off-acid suppression
• 24-hour pH on-acid suppression
• 48-hour pH off-acid suppression
• 48-hour pH on-acid suppression
• Esophageal manometry and 24-hour pH off-acid suppression
• Esophageal manometry and 24-hour pH on-acid suppression
• Esophageal manometry and 48-hour pH off-acid suppression
• Esophageal manometry and 48-hour pH on-acid suppression
• 24-hour pH-impedance off-acid suppression
• 24-hour pH-impedance on-acid suppression
• Esophageal manometry and 24-hour pH-impedance off-acid suppression
• Esophageal manometry and 24-hour pH-impedance on-acid suppression

Wireless pH testing (Bravo™)

The wireless esophageal pH capsule (Bravo™) is a test used to measure the amount of stomach acid that refluxes up into the esophagus. During the upper endoscopy (EGD), the capsule (which is about the size of a large gel cap) is attached to the lining of your esophagus. The Bravo™ capsule measures the acidity in the esophagus and transmits this information to a receiver that you will need to keep near you for the duration of the study.

Your doctor will specify the duration of the study and if you need to continue medication for acid suppression or stay off of it for a week before the test.

Along with the receiver, you will be given instructions on how to record your symptoms using a diary and the receiver during the test. After the study is complete, you need to return the diary and the Bravo™ receiver to the Medical Procedure Unit, so that the data can be downloaded and interpreted by a gastroenterologist. Detailed instructions about this and any acid reflux medication that you usually take will be provided to you by a nurse on the day of your appointment.

Five to several days after placement, the Bravo™ capsule naturally falls off and is eliminated from the body with a bowel movement.

Please note: You should not have this test if you have a nickel allergy, a pacemaker, an implanted defibrillator, esophageal varices, strictures, or if you tend to bleed. Also, do not have an MRI for 30 days following the procedure, or if you are not certain that you have passed the capsule in your stool. Undergoing an MRI while the capsule is still inside you can result in serious damage to your body.

Wireless pH test (Bravo™) is used to diagnose or evaluate: Acid reflux.

Your physician may order one of the following tests: Download prep instructions

• 48-hour Bravo™ off-acid suppression
• 48-hour Bravo™ on-acid suppression
• 96-hour Bravo™

Modified barium swallow study (MBSS)

This test is performed by a speech pathologist in the Radiology Department. It uses fluoroscopy, so that the speech pathologist can see how liquid and food move through the throat into the esophagus.

Modified barium swallow is used to diagnose or evaluate: Aspiration, dysphagia, and cricopharyngeal bar.

If this test has been ordered by your gastroenterologist, and you have questions about how to schedule or prepare for your appointment, please speak with your doctor's office.

More about modified barium swallow study (MBSS)

Esophageal burger study

This test is performed by the Radiology Department. It uses fluoroscopy, so that the radiologist can see how food moves through the throat into the esophagus.

Esophageal burger study is used to diagnose or evaluate: Dysphagia.

If this test has been ordered by your gastroenterologist, and you have questions about how to schedule or prepare for your appointment, please speak with your doctor's office.

Fiberoptic endoscopic evaluation of swallowing

This test is performed by the Swallowing Disorders Program. A thin flexible camera is inserted through the nose, so that your throat is visible. The ear, nose and throat (ENT) doctor will be able to observe your swallowing anatomy and function as food of different consistencies is swallowed.

Fiberoptic endoscopic evaluation of swallowing (FEES) is used to diagnose or evaluate: aspiration and pharyngeal dysphagia.

If this test has been ordered by your gastroenterologist, and you have questions about how to schedule or prepare for your appointment, please speak with your doctor's office.

More about fiberoptic endoscopic evaluation

Esophagram

This test is performed by the Radiology Department. In this test the you will be asked to drink a liquid containing barium. Barium coats the esophagus and it can be seen on x-ray. This test helps detect structural abnormalities of the esophagus.

Esophagram is used to diagnose or evaluate: Aspiration, dysphagia, and mechanical obstruction.

If this test has been ordered by your gastroenteologist, and you have questions about how to schedule or prepare for your appointment, please speak with your doctor's office.