Endoscopic Weight Loss Center
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These tests and procedures, performed by Drs. Miller and Scholl, are used to provide you with the best possible diagnosis and treatment of your digestive disorders.

Anorectal Manometry
Breath Tests

  • Helicobacter Pylori
  • Small intestine bacterial overgrowth (SIBO)
  • Lactose intolerance
  • Fructose intolerance

Capsule Endoscopy (PillCam)
Colonoscopy and Sigmoidoscopy
Esophageal Manometry/Motility Testing
Hemorrhoid Banding
pH/Impedance Testing
Upper Endoscopy

Anorectal Manometry is an outpatient test, performed in our office, used to evaluate patients with constipation or fecal incontinence (leakage of stool). This allows us to measure:

  • Strength of the anal sphincter muscles
  • Sensation of stooling in the rectum
  • Reflexes that govern the passage of bowel movements
  • Movements of the anal and rectal muscles.

Abnormalities of these anorectal functions can cause or contribute to fecal incontinence and constipation. There are treatment options if abnormalities are detected. Biofeedback techniques using anal manometry and special exercises of the pelvic floor muscles can improve muscle strength, function, and sensation. Sometimes, referral to a colorectal surgeon for further intervention is required.

Breath Testing is a noninvasive technique for detecting underlying bowel issues such as:

  • Infection with H. pylori bacteria (bacteria that can cause ulcers and increase the risk of cancer in the upper gastrointestinal tract)
  • Small intestinal bacterial overgrowth, also called SIBO (bacterial imbalance that can lead to abdominal bloating, abdominal pain, and change in bowel frequency)
  • Lactose intolerance – inability of the small intestine to adequately absorb lactose (a sugar found in all dairy), which results in abdominal bloating, abdominal pain, and diarrhea.
  • Fructose intolerance – Inability of the small intestine to adequately absorb fructose (a sugar found in all fruits), which results in abdominal bloating, abdominal pain, and diarrhea.

Breath tests are painless outpatient tests that are performed in our office.

Capsule Endoscopy (PillCam) is performed to evaluate the middle part of the gastrointestinal tract, which is called the small intestine. This part of the intestinal tract cannot be visualized by traditional upper endoscopy or by colonoscopy. This painless, outpatient test is most commonly performed to look for a source for bleeding in the small intestine. It is also done to look for Crohns disease (inflammatory bowel disease), polyps, ulcers, and tumors in the small intestine.

The test involves swallowing a pill-sized video camera. The camera has it’s own light source and records the images of the small intestine by sending them to a small recording device that is worn by the patient during the exam. The camera is not digested or absorbed. It passes through the bowels and leaves the body, usually undetected by the patient, with a normal bowel movement.

Colonoscopy and Sigmoidoscopy
A colonoscopy is an important test for colon cancer screening. It is a safe and effective way to detect and remove colon polyps before they have a chance to turn into cancer. It is also performed when people have problems or symptoms such as:

  • Abdominal or rectal pain
  • Changes in bowel habits such as chronic diarrhea or new and persistent constipation
  • Blood loss
  • Unexplained anemia
  • Active bleeding from the large bowel
  • Abnormalities that were seen on x-ray studies, such as inflammation of the colon wall found on a CT scan of the abdomen.

The term colonoscopy refers to a sedated medical procedure during which a long flexible tube is used to look inside the colon. The main instrument that is used to look inside the colon is the colonoscope. The colonoscope is a long, thin, flexible tube with a tiny video camera and a light on the end. By adjusting the various controls on the colonoscope, the gastroenterologist can carefully guide the instrument in any direction to look at the inside of the colon. The high-quality picture from the colonoscope is shown on a TV monitor, and gives a clear, detailed view.

A sigmoidoscopy is similar to a colonoscopy, but only about a third of the colon (primarily the rectosigmoid colon and left side of the colon) is examined. Since the entire colon is not examined, this test is used in limited circumstances.

Esophageal Manometry/Motility testing
Esophageal manometry is an outpatient test used to evaluate the movement (motility) of food through the esophagus and into the stomach. The test measures how well the circular bands of muscle (sphincters) at the top and bottom of your esophagus open and close, as well as the pressure, strength and pattern of the wave of esophageal muscle contractions that moves food along. This test does not require sedation.

Esophageal manometry can be used if you’re experiencing symptoms that could be related to an esophageal disorder. Those symptoms may include:

  • Difficulty swallowing (dysphagia)
  • Pain when swallowing (odynophagia)

Esophageal manometry may also be recommended if you are considering undergoing anti-reflux surgery to treat astroesophageal reflux disease (GERD) to make sure that you don’t have an underlying problem with the contraction of your esophagus that would not be helped by GERD surgery.

During esophageal manometry, a thin, flexible tube (catheter) that contains sensors is passed through your nose, down your esophagus and into your stomach. Numbing medicine is applied inside the nose to make the insertion of the tube less uncomfortable.

After the tube is in the stomach, the tube is pulled slowly back into your esophagus. At this time, you are asked to swallow. The pressure of the muscle contractions is measured along several sections of the tube. The tube is removed after the tests are completed.

Hemorrhoid Banding
Hemorrhoids are common, but that doesn’t mean you need to live with them, or the trouble they will cause. Traditional recommendations for hemorrhoid creams, suppositories, and baths may treat symptoms temporarily, but they will not eliminate the problem. This means that symptoms will return. We offer a highly effective, minimally invasive banding procedure for the treatment of hemorrhoids. This simple process is performed in our office in a matter of minutes, with little or no discomfort. There is no need for a driver, a bowel prep, or a long recovering time. In fact, you can typically return to work the same day. Hemorrhoid banding offers patients a permanent and painless solution without the discomfort or prolonged recovery time associated with other hemorrhoid removal options. We are happy to be able to provide this service to our patients. To read more about the CRH O’Regan System, please click the link below.

Click here to read the CRH O’Regan treatment brochure.

Why is CRH Better?

  • More than 99% effective
  • Fast, painless, and safer than traditional hemorrhoid banding
  • Smaller instruments mean greater comfort and faster treatment

pH/Impedance Testing is an outpatient test that measures the amount of acid or non-acid reflux of stomach contents into the esophagus over a 24 hour perior.  This test helps your doctor determine if your symptoms are due to gastroesophageal reflux disease. Symptoms that are evaluated with this test include:

  • Heartburn
  • Chest pain or discomfort that is not due to the heart
  • Chronic cough or throat clearing
  • Voice hoarseness
  • Difficulty swallowing

pH/Impedance testing is also an important part of the pre-operative evaluation for gastroesopheal reflux surgery.

This test does not require sedation. It involves passing a thin tube with sensors along its length in through the nose and down the esophagus to the level of the opening of the stomach. The sensors measure acid concentration, which corresponds to acidic reflux and impedance, which corresponds to nonacid reflux. The patient wears a data recorder during the test and record symptomatic episodes. Symptoms will be analyzed for any correlation to episodes of reflux.

Upper GI Endoscopy can be helpful in the evaluation or diagnosis of various problems that occur in the upper gastrointestinal tract (esophagus, stomach, and duodenum/first part of the small intestine). Symptoms that may be evaluated by this test include:

  • Difficult or painful swallowing
  • Heartburn
  • Chest pain that is not due to the heart
  • Pain in the upper stomach or abdomen
  • Nausea and vomiting
  • Blood in the stools or black stools
  • Unexplained anemia

An upper endoscopy is a sedated procedure that involves the gastroenterologist passing a long, thin, flexible tube through your mouth and into your esophagus, stomach, and duodenum. There is a tiny video camera and light on the end of the endoscope. A high-quality picture is shown on a TV monitor to give a clear and detailed view of the upper gastrointestinal tract lining. This is a safe and effective way of diagnosing conditions such as gastroesophageal reflux disease, ulcers, tumors, and celiac disease. Certain conditions, such as bleeding ulcers or strictures (scar tissue causing narrowing of the gastrointestinal tract) can be treated through the endoscope.

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