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The Baylor Scott & White Center for Esophageal Diseases ​provides a comprehensive consultation for the diagnosis and management of esophageal conditions. Our Baylor Scott & White multidisciplinary team and services provide state-of-the-art diagnostic testing, endoscopic services, therapeutic procedures and minimally invasive surgery.

 

Upper endoscopy

An upper endoscopy is a procedure that allows your physician to examine the lining of your upper gastrointestinal tract. A flexible, lighted tube is inserted through your mouth and into the esophagus, stomach and the first part of the duodenum. Typically, patients are sedated for the procedure. During this procedure, the physician may take biopsies (small tissue samples for analysis). In some cases, your physician may discuss additional diagnostic or therapeutic maneuvers may be performed during an upper endoscopy.

 


Barium Swallow (Esophagram)

This is a radiology test to assess the structure and the overall motor coordination of the esophagus. During this test, you swallow liquid barium which outlines the structure of the esophagus. The radiologist may also be able to comment if there is a major motor coordination problem that may prompt additional testing. Some studies also include swallowing a barium pill as part of the examination. You are awake for the procedure.

 


High-resolution manometry

High-resolution manometry is a diagnostic test performed to test the function of the esophagus and evaluate for a motility disorder of the esophagus. High-resolution manometry measures pressures throughout your esophagus. using a series of closely spaced pressure sensors on a thin catheter. The thin catheter is inserted through the nose and runs down the esophagus into the stomach and is positioned to allow for the measurements throughout the esophagus. You are awake for the procedure.

 


Wireless pH testing

Wireless pH testing allows your physician to evaluate the acid exposure in your esophagus while you continue your normal activities. During an upper endoscopic procedure, the physician places a small capsule in your lower esophagus. The capsule records activity in that area for over a 48-hour period or 96-hour period and transmits acid levels to a wireless recording device which is worn on a belt. You document meals and any symptoms during the study period. You return the recording device after the study period and then your physician is able to download the data from the recording device and analyze the data to provide information about the severity of acid reflux. The capsule will fall off on its own and does not need to be retrieved.

 


pH and Impedance testing

A pH and impedance study is an outpatient test that measures the amount of acid or non-acid reflux of the stomach contents into the esophagus. This is a catheter-based test. The catheter goes into your nose and is positioned along your esophagus with the end in the stomach. The catheter is secured on the outside and you are given a portable recording device. The sensors along the catheter demonstrate the acid exposure which reflects acid reflux and the fluid that comes up which may reflect weakly acidic or non-acidic reflux.

 


Endomicroscopy

Endomicroscopy provides real-time imaging of the gastrointestinal lining during an endoscopic procedure at the microscopic level. Endomicroscopy may be used to better detect subtle abnormalities such as a precancerous change in the lining or outline the borders of a subtle lesion to plan therapy in real time. Endomicroscopy systems that may be available include volumetric laser endomicroscopy and confocal laser endomicroscopy and each offer different resolutions and field of view.

 


Endoscopic ultrasound

An endoscopic ultrasound is an endoscopic procedure that uses a specialized endoscope which has both a camera and an ultrasound at the end of the long flexible scope. The ultrasound probe can image through the wall of the GI tract and adjacent organs in the chest and the abdomen. A needle can be inserted to sample cells for analysis if needed.

 


Endoscopic mucosal resection

Endoscopic mucosal resection (EMR) is a procedure that is performed during an endoscopy to remove the superficial tissue. The physician may remove tissue through the scope in pieces that are larger and deeper than standard biopsy samples. EMR can be used in superficial precancerous or cancerous disease in the gastrointestinal tract to both allow for a more accurate diagnosis and also for treatment by removing the diseased tissue.

 


Radiofrequency ablation

Radiofrequency ablation (RFA) is a procedure that is performed during endoscopy to destroy the lining of superficial diseased tissue with thermal energy. Your physician may use a balloon catheter or different sized probes depending on the area that needs to be treated. The goal is to treat by destroying the diseased tissue and the lining that regrows is the normal esophageal lining.

 


Cryotherapy ablation

Cryotherapy ablation is a procedure that is performed during endoscopy to destroy the lining of the superficial diseased tissue with the cycle of freezing and thawing the tissue. The therapy exposes cells to extreme cold and then allows cells to thaw to cause the death of the cells in the targeted area. The goal is to treat by destroying the diseased tissue and the lining that regrows is the normal esophageal lining.

 


Heller myotomy (Laparoscopic)

A laparoscopic Heller myotomy is a minimally invasive surgical procedure used to treat achalasia. This is a surgical procedure which uses several small incisions to utilize small cameras and instruments to cut the muscle of the lower esophagus in patients with achalasia.

 


Peroral endoscopic myotomy (POEM)

Peroral endoscopic myotomy (POEM) is a novel therapeutic endoscopic procedure used to treat achalasia. The procedure is a minimally invasive alternative to a surgical procedure and uses the endoscope to enter the wall of the esophagus and access and cut the muscle of the lower esophagus in patients with achalasia.

 


Antireflux surgery

A surgical fundoplication is a surgical procedure to provide additional support the to lower esophageal muscles to reduce fluid from coming up from the stomach into the esophagus. It is considered in some patients with acid reflux disease. The surgeon wraps the top portion of the stomach around the junction of the esophagus and the stomach to reduce the reflux of contents back into the esophagus.

 


LINX procedure

The LINX procedure is a novel minimally invasive surgical procedure in which the surgeon places a ring of magnetic beads around the lower portion of the esophagus to create more support to reduce the reflux of contents back into the esophagus.

 


Colonoscopy

A colonoscopy is an endoscopic procedure to examine the inner lining of your large intestine, or rectum and colon. A thin, flexible tube called a colonoscope is inserted into the rectum and steered through the colon by the physician to look at the lining for any abnormalities. Biopsies may be performed to sample the tissue. If identified, polyps may be removed through the scope.