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Advanced Investigations

ERCP (Endoscopic retrograde cholangiopancreaticography)

It is a type of endoscopy that allows imaging of the pancreas, bile ducts and adjacent structures and simultaneous removal of bileduct stones/sludge/pancreatic stones. It is also used to place stents for strictures even obviating the need of surgery in select cases.

Endoscopic Ultrasound(EUS)

It is the most sensitive test for the imaging of biliary and pancreatic duct, pancreatic parenchyma including calcifications. Endoscopic ultrasound guided drainage of pancreatic fluid collection is widely accepted as effective non surgical management strategy.

    Esophageal manometry

  • Esophageal manometry is a test that evaluates the function of the lower esophageal sphincter (the valve that prevents reflux, or backward passage, of gastric acid into the oesophagus) and the esophageal muscles. This test will tells if your oesophagus can usually transfer food to your stomach.

  • A short, flexible tube is passed through one’s nose, oesophagus, and stomach. The tube does not obstruct your breathing. The tube is linked to a machine that graphs the contractions of the esophageal muscles.

  • One will be asked to swallow a tiny amount of water throughout the test to see how effectively the sphincter and muscles are performing. The sensors also monitor the strength and coordination of esophageal contractions (spasms) while one swallows.

  • The examination lasts 10 to 15 minutes. The tube is removed once the test is completed. The recordings made during the test will be interpreted by the doctor.

  • Anorectal manometry for Hirschsprung's/Defecatory disorders

  • Anorectal manometry (ARM) is a noninvasive technology for assessment of constipation problem. ARM involves dilation of a rectal balloon and measurement of the response in anal sphincter pressure. Rectal balloon stimulation causes a rectoanal inhibitory reflex (RAIR) . The RAIR is missing in Hirschsprung's disease patients .

pH impedance monitoring

Esophageal 24-hour pH/impedance reflux monitoring examines whether symptoms are associated with the reflux and measures the quantity of reflux (both acidic and non-acidic) in oesophagus over a 24-hour period.