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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