GI Motility

Referring Providers

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Proper diagnosis and treatment of GI motility disorders can significantly improve your health and quality of life. Call 310-825-2631 to connect with a specialist.

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Referrals made easy!

We have created one-page, user-friendly forms to help streamline the referral process for you and your staff. Once completed, they can be faxed to 310-825-5176.

CareConnect referral instructions for UCLA healthcare professionals

UCLA healthcare professionals should follow these instructions for referrals.

Referral form for non-UCLA healthcare professionals

For non-UCLA healthcare professionals, patients can be referred for motility procedures with or without endoscopy.

  

   

Listed below is guidance for choosing the appropriate pH test

Esophageal manometry must be performed prior to the pH study to determine LES location for all catheter-based pH tests, if the patient has never had an esophageal manometry before. It is also essential that patients undergo esophageal manometry before surgical or endoscopic treatment for reflux.

For all Bravo studies, EGD MUST be ordered.

48-hour Bravo OFF acid suppression
(OFF acid suppression = OFF PPI for 7 days, OFF H2RA for 2 days, OFF antacid 1 day prior)

When to perform the test:

  • To determine if the patient has GERD
  • Patient has reflux symptoms despite PPI therapy
  • The patient is symptomatic s/p surgical or endoscopic treatment for GERD
  • There is no objective evidence of acid reflux such as:
    • Barrett's esophagus
    • LA grade C-D esophagitis
    • +pH test
    • Biopsy-proven esophagitis

48-hour Bravo ON acid suppression

When to perform the test:

  • To determine if the therapy is working
  • There is previous objective evidence of acid reflux such as:
    • Barrett's esophagus
    • LA grade C-D esophagitis
    • +pH test
    • Biopsy-proven esophagitis

96-hour Bravo OFF acid suppression for the first 48 hours and then ON acid suppression for the remaining 48 hours
(OFF acid suppression = OFF PPI 7 days, OFF H2RA for 2 days, OFF antacid 1 day prior)

When to perform the test:

  • To determine if there is acid reflux, and if so, whether the therapy is working
  • There is NO objective evidence of acid reflux such as:
    • Barrett's esophagus
    • LA grade C-D esophagitis
    • Previous +pH test
    • Biopsy-proven esophagitis

24-hour pH study OFF acid suppression
(OFF acid suppression = OFF PPI for 7 days, OFF H2RA for 2 days, OFF antacid 1 day prior)

When to perform the test:

  • To determine if the patient has GERD
  • Patient has reflux symptoms despite PPI therapy
  • The patient is symptomatic s/p surgical or endoscopic treatment for GERD
  • Patient cannot tolerate EGD with Bravo or has any of the following:
    • Coagulopathy (i.e., platelet <50k,INR >1.5, on acticoagulation)
    • Esophageal varices
    • Stricture
    • Ulcer
    • Esophageal obstruction
    • Bowel obstruction
    • Pacemaker or implantable defibrillator
  • There is NO objective evidence of acid reflux such as:
    • Barrett's esophagus
    • LA grade C-D esophagitis
    • +pH test
    • Biopsy-proven esophagitis

24-hour pH study ON acid suppression

When to perform the test:

  • To determine if the therapy is working
  • Patient cannot tolerate EGD with Bravo or has any of the following:
    • Coagulopathy (i.e., platelet <50k,INR >1.5, on acticoagulation)
    • Esophageal varices
    • Stricture
    • Ulcer
    • Esophageal obstruction
    • Bowel obstruction
    • Pacemaker or implantable defibrillator
  • There is previous objective evidence of acid reflux such as:
    • Barrett's esophagus
    • LA grade C-D esophagitis
    • +pH test
    • Biopsy-proven esophagitis

24-hour pH-impedance OFF suppression
(OFF acid suppression = OFF PPI for 7 days, OFF H2RA for 2 days, OFF antacid 1 day prior)

When to perform the test:

  • To determine if the patient has acid and/or non-acid reflux
  • Patient cannot tolerate EGD with Bravo or has any of the following:
    • Coagulopathy (i.e., platelet <50k,INR >1.5, on acticoagulation)
    • Esophageal varices
    • Stricture
    • Ulcer
    • Esophageal obstruction
    • Bowel obstruction
    • Pacemaker or implantable defibrillator
  • There is NO objective evidence of acid reflux such as:
    • Barrett's esophagus
    • LA grade C-D esophagitis
    • +pH test
    • Biopsy-proven esophagitis

24-hour pH-impedance ON acid suppression

When to perform the test:

  • To determine if the patient has acid and/or non-acid reflux despite therapy
  • Other indications include:
    • Hypersensitivity
    • Regurgitation
    • Rumination
    • Supragastric belching
  • Patient cannot tolerate EGD with Bravo or has any of the following:
    • Coagulopathy (i.e., platelet <50k, INR >1.5, on anticoagulation)
    • Esophageal varices
    • Stricture
    • Ulcer
    • Esophageal obstruction
    • Bowel obstruction
    • Pacemaker or implantable defibrillator