Abnormalities of the swallowing apparatus; the pharynx and esophagus, can consist of structural problems, motility disorders, inflammatory disorders or malignancies. Our center addresses the complete range of esophageal and motility disorders and involves specialists in gastroenterology, interventional endoscopy, surgery, oncology, pathology, radiology and nutrition who utilize a multidisciplinary approach to diagnose and treat esophageal disorders.Physicians in the Center for Esophageal Disorders work closely with head and neck surgeons and speech language pathologists in the Swallowing Disorders Program, led by Dr. Dinesh Chhetri,to comprehensively evaluate and treat disorders of the entire swallowing apparatus, from mouth to stomach.
The esophagus is a tube of muscle that connects the throat to the stomach. Where is connects with the throat and stomach, there are sphincter muscles that close off the ends of the esophagus.The one between the throat and esophagus is the upper esophageal sphincter, and the one between the esophagus and stomach is the lower esophageal sphincter. They keep stomach contents from backing up into the esophagus and throat.Weakness or malfunction of the sphincters leads to gastroesophageal reflux disease (GERD). When something is swallowed, the upper sphincter opens for a short time to let the food or drink into the esophagus.The esophagus pushes the food down to the stomach, and the lower sphincter opens to let food into the stomach.Failure of the sphincters to open properly or the esophagus to push the food down often leads to a sensation of food sticking in the throat or under the breastbone, called dysphagia.Malfunction of the esophagus can also cause regurgitation and/or chest pain.
High-resolution Esophageal Manometry
Esophageal manometry measures how well the esophagus and its sphincters work. This test is done with a thin catheter that has many pressure sensors along its length. After numbing the nasal passages the catheter is introduced into the nose and advanced slowly until located in the esophagus so that function of the esophagus and sphincters can be measured. After a rest period, the patient is asked to swallow small amounts of liquid and jello-like material. Esophageal manometry is used primarily in patients who have swallowing difficulties after their doctor determined that no abnormality is blocking the esophageal passageway. Esophageal manometry can diagnose weak or failed function of the esophagus and/or its sphincters.
High-resolution Impedance Esophageal Manometry
High-resolution Impedance esophageal manometry is identical to high-resolution esophageal manometry except it also sees the swallowed material as it moves in the esophagus. It can tell if the swallowed material successfully empties into the stomach.
High-resolution 3D Esophageal Manometry
High-resolution Impedance esophageal manometry is identical to high-resolution esophageal manometry except it also gives a 3-dimensional view of how the esophagus works. It is most useful in determining how the esophageal sphincters function.
Dual Channel Intraesophageal pH Testing
Intraesophageal pH testing determines how much acid backs up from the stomach into the esophagus. The dual channel pH probe is a thin wire that has 2 tiny pH sensors on it. After numbing the nasal passages it is introduced into the nasal passage and advanced slowly until located in the esophagus so that one pH sensor is just above the lower esophageal sphincter and the other is just below the upper esophageal sphincter. The wire that is outside the nose is connected to a recording device that is carried by the patient for 24-hours. At the end of 24 hours, the wire is removed and the pH information is transferred to a computer for analysis.
Intraesophageal Impedance pH Testing
Intraesophageal impedance pH testing is identical to standard pH testing except that it identifies movement of stomach contents into the esophagus whether it is acid or not.
Wireless Intraesophageal pH Testing (BravoTM pH Capsule)
Wireless intraesophageal pH testing allows us to see how much acid comes up into the esophagus over 48 to 96 hours. It is a tiny capsule that contains a pH sensor, batteries and radio transmitter. At the time of endoscopy, it is attached to the inner lining of the esophagus just above the lower esophageal sphincter. It transmits pH information to a recording device that the patient carries for 48-96 hours. At the end of the recording time, the pH information is transferred to a computer for analysis. On average, the pH capsule falls off in 5 days and expelled.
Jeffrey Conklin, MD
Medical Director, UCLA Center for Esophageal Disorders
Director, Gastrointestinal Motor Function Laboratory
310-208-5400 - Patient Appointments
Kevin Ghassemi, MD
Director, Clinical Programs
UCLA Center for Esophageal Disorders
310-208-5400 - Patient Appointments