EUS

Endoscopic Ultrasound (EUS) is a new technology that provides highly detailed images of the digestive system. EUS is a cost-effective, non-surgical technique to assess a majority of GI and lung cancers and many non-malignant GI conditions such as chronic pancreatitis and perianal fistulas related to Crohn’s disease. At Vanderbilt, we utilize many different types of EUS transducers including a radial echoendoscope to help make the best diagnosis. Physicians also use EUS to guide pseudocyst drainage, and injections for pain relief treatments.

Biliary and Pancreatic Manometry

Manometry is the gold standard for diagnosing Sphincter of Oddi dysfunction. During a procedure known as endoscopic retrograde cholangiopancratography (ERCP), a flexible lighted endoscope is passed through the mouth, esophagus, stomach, and into the small intestine. A specialized catheter is then advanced through this endoscope and into the bile and pancreas ducts. If disorders are present, appropriate treatment consisting of stent placement or a cauterized incision of the sphincter (endoscopic sphincterotomy) may then be performed.

Manometry is only available at selected tertiary referral medical centers; Vanderbilt is the only institution in Tennessee equipped for the procedure.

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Bile Analysis

Despite advances in imaging studies, the diagnosis of small gallstones or sludge in the bile ducts remains elusive at times. Since such disorders may lead to attacks of pancreatitis, abdominal pain, or obstruction of the gallbladder, seeking a diagnosis of small gallstones with additional tests such as microscopic analysis of the bile may be necessary. During ERCP, bile is collected and sent to the laboratory, where it is analyzed for small gallstones under the microscope.

Wireless pH Monitoring

This test allows physicians to discriminate between symptoms associated with GERD and those unrelated to reflux disease. The warless (catheter free) system is the most advanced type of pH monitoring and provides the highest level of patient comfort.

Impedance/pH Monitoring

This technique is used to test for GERD and esophageal functioning. It is often used in place of a barium swallow test. Impedance/pH monitoring lets physicians better evaluate acid and non-acid reflux in patients with GERD symptoms.

HRM High Resolution Monometry (HRM)

HRM is an advanced test to measure the function of the esophagus. By compiling a pressure profile over the entire esophagus, a more accurate diagnosis can be made.

Bilitec

Bilitec is a fiber optic means of measuring bile reflux. This test is especially important because it allows physicians to determine if factors other than acid may be present in patients with GERD. It is often used after gastric surgery to assess bile reflux.