Diagnostic Testing

Diagnostic Testing and Studies

Diagnostic studies performed at the center

Upper GI X-ray (UGI)

• This test may demonstrate reflux of the swallowed barium and will help spot abnormalities such as a hiatal hernia and other structural or anatomical problems of the esophagus.
• It will not detect mild irritation, although strictures/narrowing of the esophagus and ulcers can be observed.

Upper endoscopy (EGD)

• While you are sedated, a doctor inserts an endoscope through the mouth and into the esophagus, stomach and first section of the small intestine. It features a camera, allowing for the evaluation of the surface of these structures and the detection of abnormalities.
• The doctor also may perform a biopsy. Small instruments are passed through the endoscope, allowing the doctor to remove small pieces of tissue from your esophagus. The tissue is evaluated under a microscope to facilitate diagnosis and guide therapy.

Bravo Study

• See EGD description above.
• The test involves attaching a capsule to your lower esophagus to measure acid exposure in the lower esophagus over several days. The data is recorded on a wireless monitor. Only sensitive to acid reflux.

What Is Bravo pH Testing?

The Bravo pH test is a wireless test that measures acid reflux in the esophagus to help diagnose gastroesophageal reflux disease (GERD). It involves placing a small capsule in the esophagus that transmits pH data to a receiver worn by the patient. 

The Bravo pH test is a minimally invasive procedure that utilizes a small, capsule-like device to monitor the amount of acid in the esophagus over a period of 48 or 96 hours. 

How it works

1. A gastroenterologist attaches the Bravo capsule to the esophageal lining during an endoscopy procedure. 
2. The capsule measures the pH (acidity) in the esophagus and transmits this data wirelessly to a small receiver that the patient wears. 
3. Patients keep a diary to record their symptoms, meals, and sleep patterns during the monitoring period. 
4. After the monitoring period, the patient returns the receiver and diary to the doctor for analysis. 
5. Doctors analyze the data to determine the frequency and duration of acid reflux episodes and correlate them with the patient's symptoms. 

Why it is done:

The Bravo pH test helps doctors diagnose GERD, determine the severity of acid reflux, and assess whether a patient's symptoms are related to acid reflux.

Who should get it:

Patients experiencing symptoms such as heartburn, chest pain, coughing, sore throat, or hoarseness, which may be related to acid reflux, may be candidates for the Bravo pH test. 

Important Considerations:

• Patients with pacemakers, implantable defibrillators, or neurostimulators should not undergo this test. 
• Patients should inform their doctor about any bleeding tendencies, esophageal narrowing, severe esophagitis, or other conditions that could affect the test. 
• Patients should avoid having an MRI for 30 days before and after the test. 
• Patients should follow their doctor's instructions regarding medications and fasting before the procedure. 
• Patients should keep the receiver dry and avoid getting it wet during the test. 
• Patients should return the receiver and diary to the doctor after the test. 

Esophageal Manometry

• This test monitors the strength and coordination of the contractions in the esophagus and lower esophageal sphincter. 
• It is used to identify problems with swallowing and to guide surgical and medical management.