Investigations

Our physiological investigations include:

High resolution oesophageal manometry

This is a test to measure the pressures in your oesophagus (gullet) and the valve separating your stomach and oesophagus.

You can read our information sheets on high resolution oesophageal manometry, including for rumination.

We also offer this investigation for children while they are awake, either on the children's ward or in one of our endoscopy rooms. Depending on your child's age, we may be supported by a play therapist and children's nurses.

Oesphageal pH and impedance measurement

We can measure fluid movement from your stomach into your oesophagus (gullet) during an extended period of normal activity, and also check for acid and non-acid reflux. Read more in our information sheet.

We also perform these studies for children. Studies over 24 hours are carried out by the specialist nurses on the children's ward. We help with more complicated patients.

You can also read our reflux advice sheet.

Bernstein testing

Sometimes called an acid perfusion test, this assesses whether your chest pain or heartburn is secondary to your oesophagus being particularly sensitive to acid. A weak solution of acid and saline is dripped into your gullet using the catheter inserted via your nose for the oesophageal manometry study. We periodically wash away the acid then reintroduce it, to see if your symptoms are linked to the acid being present.

Hydrogen and methane breath testing

Bacteria can grow in your small intestine and interfere with the digestion of food; this is a condition known as small bowel bacterial overgrowth (SBBO). When bacteria digest sugar they produce hydrogen or methane, which escapes from your gut via your lungs. By measuring the hydrogen or methane in your breath over a period of time, we can see if SBBO may be causing your symptoms. We can also use this assessment to measure lactose and fructose intolerances.

High resolution anorectal manometry

If you're having trouble opening or controlling your bowels, an anorectal manometry or physiology test can help us to find out why. We use a thin tube (catheter) to measure the pressure inside your anus and rectum to see how well the muscles are working.

Read our patient information on having an anorectal physiology test.

We are one of only a few centres in the country to performing anorectal manometry in children who are awake. Depending on your child's age, we will usually be supported by a play therapist and children's nurses. We will usually perform the procedure in one of our clinical rooms in the endoscopy department.

Endoanal ultrasound

We can use ultrasound to look at the rings of anal muscle (sphincters). We'll check if you have any areas of scarring or damage to the muscle, caused by things such as childbirth.

Pelvic floor scanning

Our pelvic floor surgeons use an ultrasound machine with special probes to perform a full pelvic floor scan. They can look at the internal anatomy of your pelvis, anus, rectum and vagina.

Barostat measurement of rectal compliance

We would usually perform a barostat measurement as part of the anorectal physiology investigation. A thin tube (catheter) with a bag attached to the end is passed into your rectum. We fill the bag with air, and use this to map the shape of your rectum. This gives us an accurate idea of the size of your rectum and how flexible the walls of your rectum are. We can also get sensory information relating to how much information you're getting from your rectum when you need to go to the toilet.