A number of gastrointestinal investigations apart from endoscopy may be very helpful in establishing a diagnosis and in deciding the best treatment. These include:

Oesophageal physiology studies (pH, manometry and impedence monitoring)

These tests are used for the assessment of oesophageal function (motility) and the investigation of acid reflux and swallowing problems. They are important to do if surgical or endoscopic therapy is being considered. The tests involve passing a small inflatable balloon via a catheter into the oesophagus (gullet) to measure the pressure and motility of the oesophagus (oesophageal manometry) which only takes a few minutes. A different type of catheter (a pH probe inserted gently through the nose) is used to measure acid levels (oesophageal pH studies) or else a special wireless capsule (the Bravo capsule) can be placed within the lower oesophagus during gastroscopy.

PH studies are usually performed over 24 hours (but may be up to 96 hours with the Bravo capsule). Patients are able to take the equipment home during this time and return it at the end of the test.

Rather than measuring acid, an alternative test known as oesophageal impedence monitoring can measure whether gas or liquids are refluxing up the oesophagus and causing symptoms. This is helpful for people who suffer from regurgitation that is non or weakly acidic which would not be detected by a pH probe.

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