·         24-Hour pH Study – measures how much and how often stomach acid flows into the lower esophagus during a 24 hour period. A tiny measurement device is attached to the lining of the esophagus during an EGD (see below).  Over 24 hours, the acidity in the lower esophagus is is transmitted wirelessly to a carried recording device. When the patient experiences reflux or other symptoms, he/she presses a button on the recorder. This allows us to relate symptoms to the acidity levels measured by the probe. The recording is then analyzed, and a full report is sent back to the physician. The attached recorder in the esophagus falls off in 2-3 days and is expelled in the feces and can be flushed down the toilet.

·         Colonoscopy – this is camera-assisted study of the internal structures and tissues of the entire large intestine, which is also known as the colon, the rectum, and the anus.  Samples of tissue (known as biopsies) can be taken at the time of the procedure.  The colonoscope is a long, flexible tube that has a lighted video camera at the tip end and a directional dial at the head of the scope, which the doctor uses to maneuver the tip around the curving pathways of the bowel.  Instruments used in colonoscopy run through the length of the scope and enter through a port near the directional dial.  Preparation for the test includes a bowel cleansing routine to clear any stool from the colon, and nothing to eat or drink after midnight on the day of the test.  It is usually performed as an outpatient procedure and may require mild sedation and pain medicine to maintain comfort.  You will need someone who can drive you home afterwards if you received sedation or pain medication

·         EGD –  (esophagogastroduodenoscopy) is a camera-assisted study of the internal structures and tissues of the esophagus, lower esophageal sphincter, stomach, pyloric valve, and duodenum.  The EGD uses a moderately long flexible tube that has a lighted video camera at the tip end and a directional dial at the head of the scope, which the doctor uses to maneuver the tip around the curving pathways of the throat, stomach, and upper small bowel.  Instruments used in the EGD run through the length of the scope and enter through a port near the directional dial.  Preparation for the test requires that the patient does not eat or drink after midnight on the day of the test.  It is usually performed as an outpatient procedure with mild sedation and pain medicine.  You will need someone who can drive you home afterwards if you receive sedation or pain medications that will interfere with you ability to operate a motor vehicle safely.

·         ERCP – (endoscopic retrograde cholangiopancreatography) is used as a diagnostic and therapeutic procedure to manage gall bladder duct (biliary) obstruction because of gallstones and strictures (excessive narrowing).  ERCP is also used in the diagnosis of pancreatic disease.  It involves a small internal camera that is able to fit into very narrow spaces can also deliver delicate instruments into those spaces at the same time.  It is usually performed as an outpatient procedure with mild sedation and pain medicine.  You will need someone who can drive you home afterwards because the mediations will interfere with you ability to drive safely for several hours.

·         Esophageal Motility/Manometry – a study of the how the esophagus moves fluids and foods from the throat to the stomach.  A tube with pressure gauges along its surface is inserted into the esophagus.  The force of the contractions of the esophagus is measured to determine whether they are strong enough to move food from the throat to the stomach effectively.  A similar device is sometimes used in the bowel to determine if the contractions of the bowel are forceful enough to move stool effectively through the colon to the rectum.

·         H.Pylori Breath Test – a test to measure the presence of an acid-loving bacteria, called heliobacter pylori, known to have a strong association with the formation of stomach ulcers.

·         Liver Biopsy – sometimes it is necessary to take a sample of liver tissue to diagnose certain types of liver disease with accuracy.  This can be accomplished using special, hollow tubes and a needle to capture a ‘pinch’ of tissue, which is then used by a doctor called a pathologist to prepare a series of microscope slides from the tissue sample to determine the ‘histology’ or cellular structures of the liver tissue.   This procedure is performed in the Radiology department.

·         PEG Placement – (Percutaneous Endoscopic Gastrostomy) This procedure places a feeding tube into the stomach using the endoscopic approach, a small amount of local anesthetic and sedation.  It is appropriate for patients who have difficulty with the mechanics of eating, neurologic disease that causes the loss of appetite, or those with disease that prevent normal eating, swallowing, or digestion.

·         Remicade Infusion – Remicade is a powerful drug used to treat autoimmune disorders like Crohn's disease and rheumatoid arthritis.

·         Sigmoidoscopy – this is camera-assisted study of the internal structures and tissues of the lower large intestine, the rectum, and the anus.  Samples of tissue (known as biopsies) can be taken at the time of the procedure.  The sigmoidoscope is a long, flexible tube that has a lighted camera at the tip end and a directional dial at the head of the scope, which the doctor uses to maneuver the tip around the curving pathways of the bowel.  Instruments used in sigmoidoscopy run through the length of the scope and enter through a port near the directional dial.  Preparation for the test includes a bowel cleansing routine to clear any stool from the colon, and nothing to eat or drink after midnight on the day of the test.  It is usually performed as an outpatient procedure but not ordinarily used, so you may drive yourself to and from the appointment.

·         Capsule Endoscopy– this is an endoscopic procedure using a camera inside a swallowed capsule.  As the camera capsule passes through the tissues of the gastrointestinal tract, images are transmitted for review.

·         Barrx Thermal Ablation - A new and highly effective method or thermal ablation of Barrett's esophagus.