Diagnostic Testing and Treatments Available

24 hour pH Impendence Study: Measurement of acid and non-acid reflux in patients with dysphagia, motility disorders, GERD or Barrett's esophagus by placing a small catherter through the nose into the esophagus that is connected to a small recorder that is worn for 24 hours.

Anorectal Manometry: This test is performed to help diagnose dysfunctions of the anal sphincter that cause constipation and/or incontinence.

Anoscopy: This test in done in the office to visualize the anal canal and distal rectal mucosa. Hemorrhoids and anal fissures can be diagnosed in this manner.

Bravo pH Monitor Study: This study is done to measure acid and non-acid reflux in patients with dysphagia, motility disorders, GERD or Barrett's esophagus. A small capsule is temporarily attached endoscopically to the esophagus which transmits readings to a small receiver worn for 48 hours. The recorder is returned to the Endoscopy Suite 48 hours after the procedure.

Biliopancreatic Manometry: This endoscopic test is used to determine if there is an abnormality with the pressure at the pancreatic or biliary duct. This is most often done for patients experiencing abdominal pain associated with gallbladder disease.

Colonoscopy: This test is done for screening and diagnostic purposes. Polyps, inflammation, and any other irregularities are found as the lumen of the colon and the rectum are visualized. Necessary brushings or biopsies can be performed as indicated during the procedure. A screening colonoscopy is the most effective manner of preventing colon cancer.

EGD (upper endoscopy): The entire esophagus, stomach, duodenum and sometimes the first part of the jejunum are viewed through a fiberoptic scope to assess for tumors, erosions, ulcers, or determine the cause of bleeding or other abnormalities.

Endoscopic Ultrasound: This new, highly advanced technology is the passage of an ultrasound probe on the tip of an endoscope which allows more efficient staging of esophageal, gastric, pancreatic, and rectal cancers. This procedure also enables the endoscopist to better characterize submucosal lesions.

ERCP: Endoscopic Retrograde Cholangiopancreatography testing is done for diagnostic or therapeutic reasons. This test allows the physician to visualize the pancreatic and common bile duct as well as the entire biliary tract including the gallbladder and to be able to therapeutically perform pressure measurements, stone removals, tube/stent insertions and changes, dilations, tumor ablations, and other necessary therapies.

Esophageal Manometry: This test is done by passing a small, thin, pliable tube with sensors through the patient's nose down the esophagus to measure the pressure of the contraction waves of the muscles of the esophagus and/or the gastroesophageal junction in order to diagnose abnormalities of the esophageal sphincters that affect swallowing and can cause GERD.

Esophageal Radiofrequency Ablation: This procedure is used to treat Barrett's esophagus which is the growth of abnormal tissue in the esophagus which has the potential to develop into cancer. The ablation therapy is done with a balloon passed through an endoscope into the esophagus where ablative energy is delivered to the esophageal lining and removes the abnormal tissue. With proper follow-up care, healthy esophageal tissue is formed as part of the healing process.

Fine Needle Aspiration: Fine-needle aspiration of cysts and abnormal growths is performed using an endoscopic ultrasound scope guidance where a needle can be passed through the stomach or duodenal wall into the cyst or growth under direct visualization. This allows fluid to be taken from the cyst and cancer cells sought. Patients with cancerous or pre-cancerous conditions are able to undergo timely surgery and those without life-threatening medical conditions, can avoid unnecessary surgery.

Flexible Sigmoidoscopy: This test is done to view the lumen of the sigmoid colon and rectum to determine if abnormalities are present.

Hydrogen Breath Testing: This test measures the hydrogen in exhaled breath to test for a number of conditions that cause gastrointestinal symptoms. It can be used to diagnose lactose intolerance, bacterial overgrowth, or rapid oral-cecal gastrointestinal transit time.

Ileoscopy: University Gastroenterology endoscopists are able to perform endoscopy through an ileoscopy to obtain brushings or washings or to visualize the small bowel lumen.

Liver Biopsy: Interventional Radiologists at University Hospital perform percutaneous liver biopsies for diagnosing chronic liver disease and assessing the degree of liver damage (staging of fibrosis).

Paracentesis: University Gastroenterology endoscopists perform this procedure to drain excessive fluid from the abdominal cavity.

Peg Tube Placement and Management: Percutaeous Endoscopic Gastrostomy Tubes are placed for patients who are malnourished or may have trouble eating or drinking due to dysphagia (difficulty swallowing) or malabsorption.

Photofrin Laser Therapy: This procedure is performed for the ablation of high grade dysplasia in Barrett's esophagus patients who do not undergo esophagectomy. This process is a 2-stage process requiring administration of both drug and light which, in combination, can cause cellular damage and tumor death. Patient's undergoing this therapy will be photosensitive for a minimum of 30 days.

PillCam Esophageal and PillCam Small Bowel: University Gastroenterology was the first gastrointestinal practice in the Syracuse Area to introduce PillCam testing. This group remains one of, if not the most active, in Central New York in utilizing capsule endoscopy with referrals for this testing coming from all over New York State. The small bowel technique has proven invaluable in the evaluation of patients with occult gastrointestinal bleeding, polyps of the small intestine, tumors of the small intestine, and initial diagnosis of Crohn's Disease. The esophageal technique remains in the infancy stages for recognition by the insurance payers but has proven it's value for evaluating esophageal varices and Barrett's.

Small Bowel Enteroscopy: University Gastroenterology endoscopists perform this test to visualize the lumen of the small bowel and to obtain specimens of suspicious areas, if necessary.

Stool Occult Blood Testing: Stool guaiac testing cards are given to patients to collect stool specimens for the purpose of testing the stool to detect the presence of blood in the stool.