Other digestive tests
Different tests answer different questions. Your doctor can discuss whether further investigation is useful in light of your symptoms, history and initial results.
Video capsule endoscopy
A video capsule is a swallowable camera that travels naturally through the digestive tract and sends pictures to a recorder. It is mainly used to examine the small bowel, which a standard gastroscopy or colonoscopy cannot view in full. Your doctor may consider it when looking for a source of small-bowel bleeding or investigating certain suspected small-bowel conditions. The images are reviewed after the examination; the capsule cannot be steered in real time.
It takes pictures only: it cannot collect a biopsy, remove a polyp or treat a finding. Another procedure may be needed if something requires sampling or treatment. A narrowed bowel can trap the capsule. Tell your doctor about a suspected obstruction, previous bowel surgery or known narrowing so they can decide whether this test is suitable or whether another check is needed first.
The diet, fasting and recorder instructions depend on the arrangement made for you. Ask the nurses how to wear the recorder, when to eat and when to return the equipment; do not use another patient’s preparation instructions.
Bravo wireless pH monitoring
Bravo measures acid exposure in the oesophagus. A small wireless capsule attached to the oesophageal wall records acidity over a period of time and sends readings to a portable receiver. Comparing that record with a diary of symptoms and meals can help your doctor assess whether acid exposure relates to what you feel. It answers a different question from a gastroscopy, which shows the appearance of the lining.
The capsule usually detaches and passes naturally later. Some people notice temporary chest or swallowing discomfort. Bravo measures acidity, so it cannot identify every episode of non-acid reflux and does not replace an examination of the oesophageal lining. Whether it is helpful depends on your symptoms, earlier test results and treatment history.
The monitoring period, symptom diary and whether to pause acid-suppressing medicine must be decided for you individually; do not stop medicines yourself. Tell the team about implanted devices or a planned MRI during the monitoring period so they can check the particular device’s safety instructions.
Oesophageal manometry
Manometry measures the strength and coordination of oesophageal muscle contractions and the activity of its sphincters as you swallow. A fine catheter is usually passed through the nose into the oesophagus, and you are asked to take small swallows of water. The results can help investigate difficulty swallowing or a suspected disorder of oesophageal movement.
A gastroscopy looks at the inner lining; manometry examines how the oesophagus works. The two are not interchangeable. It may also be requested during reflux assessment or before certain treatments. Placing the catheter can cause brief nose or throat discomfort; the team will explain the specific process and expected duration for your appointment.
Tell the team about your medicines and any nasal or swallowing difficulties when booking. Follow the fasting and medicine instructions given for your own test, and contact the nurses beforehand if anything is unclear.
ERCP
Endoscopic retrograde cholangiopancreatography (ERCP) combines an endoscope and X-ray imaging. The endoscope passes through the mouth to the duodenum, where the doctor can access the opening of the bile and pancreatic ducts. ERCP may be used to treat certain bile-duct stones, a blocked duct or a condition needing a stent. If the question is diagnostic only, less invasive imaging such as ultrasound or MRI/MRCP may be considered first.
ERCP is not the same as a routine diagnostic gastroscopy. Possible complications include pancreatitis, bleeding, infection and perforation; your doctor will discuss the expected benefit and your personal risks. Treatment might involve removing a stone, widening an opening or placing a stent, depending on what is found.
In Dr Ng’s practice, ERCP is arranged only in hospital, as a day admission or an overnight stay, not at an outpatient centre. Tell the team about medicines (especially blood thinners), allergies, other conditions and past anaesthetic problems. Fasting, sedation and admission plans are explained after assessment.
Professional references
Contact the practice
Consultations and endoscopy are by appointment, Monday to Saturday. Phone lines may be busy; please contact the nurses via WhatsApp where possible.
Personalised clinical advice depends on an individual assessment.
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