A 23 year old lady presented with stomach pain, heartburn, regurgitation, nausea/vomiting and dysphagia.  High resolution manometry and  24-hour pH-impedance investigations were carried out. High Resolution Manometry HRM results showed the following: Based on Chicago classification, the patient was deemed to have ineffective oesophageal motility (IOM). 24-hour pH-Impedance Reflux Monitoring Off PPI The pH-impedance reflux […]

The journey from diagnosis to treatment should be straightforward, with as little burden on the patient as possible.  Unfortunately, this is not always the case. It can often take around a year for gastroenterology outpatients to get the correct testing, diagnosis and consequently the right treatment for their symptoms – and often at expense to

A 66-year-old lady presented with epigastric pain, heartburn, regurgitation, belching, high dysphagia and odynophagia.  Her OGD showed a hiatus hernia and barium swallows – tertiary contraction and reflux. Initially high resolution manometry was carried out with a further 24-hour pH-impedance test due to HRM results. High Resolution Manometry HRM results showed the following: These results

The patient was a 53-year-old lady presenting with a cough, LUQ pain and occasional dysphagia.  She had previously undergone high-resolution manometry which showed ‘normal oesophageal motility’ based on Chicago Classification.  Her previous 24-hour pH-impedance showed mainly pathological postprandial reflux.  A 24-hour pH-impedance reflux monitoring test on PPIs was carried out.  The patient was taking 80

A 16-year-old boy presented with IBS-like symptoms of chronic abdominal pain and diarrhoea.  A clinical diagnosis of small intestinal bacterial overgrowth (SIBO) was made. Hydrogen Breath Test A hydrogen breath test was carried out using 75g of glucose, the patient had followed a restricted diet the previous day and fasted overnight.  Methane levels in the

A 61-year-old patient presented with chest pain, heartburn, regurgitation and mid/low dysphagia.  AN OGD showed mild gastritis and there was no hiatus hernia visible. High resolution manometry and 24-hour pH/impedance reflux monitoring was carried out. High Resolution Manometry HRM results showed the following: These results based on the Chicago Classification indicated Type II Achalasia (with

A 44-year-old lady presented with stomach pain, heartburn, regurgitation, belching and mid/low dysphagia.  She had previously undergone a gastric sleeve procedure in 2015 which was followed by a gastric bypass in 2018. High resolution manometry and 24-hour pH/impedance reflux monitoring was carried out. High Resolution Manometry HRM results were as follows: These results based on

This 27-year-old patient presented with postprandial epigastric/stomach pain and a high level of dysphagia.  Her OGD was normal with MBI = 14 and Lupus A.  Stationary high- resolution manometry with impedance was carried out. High-Resolution Manometry HRM results were as follows: These results based on the Chicago Classification showed that the patient exhibited normal oesophageal

A 20-year-old lady presented with heartburn, belching and persistent hiccups.  High resolution manometry and 24-hour pH/impedance reflux monitoring were carried out. High Resolution Manometry HRM results were as follows: These results based on the Chicago Classification showed that the patient exhibited normal oesophageal motility. 24-hour pH-Impedance Reflux Monitoring Off PPI The pH-impedance reflux monitoring gave

Do you have patients with recurrent belching that cannot be explained by physiological changes?  If so, the patient may be suffering from supragastric belching, a behavioural condition which may benefit from oesophageal biofeedback therapy. So, firstly let’s look at this condition and how it manifests itself. As we are all aware, belching is normal!  It