As a specialist in gastro-oesophageal disease, Mr Clarke offers the most up-to-date investigation techniques including endoscopy, high resolution manometry, 24-hour pH & impedance testing.
Oesophageal physiology studies are a series of investigations that are used to accurately assess the muscle function in your gullet (oesophagus) and stomach, as well as measure levels of acid reflux over at least a 24 hour period. They involve two key investigations, a high resolution manometry test and 24-hr pH / impedance test.
This test is often recommended in patients who are being considered for anti-reflux surgery, in order to assess how well the muscles of the gullet are functioning and whether there is a link between acid reflux and a patient’s symptoms. It is also valuable in the investigation of patients with difficulty swallowing (dysphagia), to exclude disorders affecting the muscles of the oesophagus (gullet) such as achalasia or distal oesophageal spasm.
NB If you have any allergies please inform the practitioner carrying out your test. If you are pregnant, please inform the department by telephone before your appointment.
This is a procedure in which a thin flexible telescope is passed via the mouth to examine the lining of the oesophagus (gullet), stomach and small intestine (duodenum). It has a tiny light and a camera at one end that enable the images to be displayed on a television screen.
This may be recommended to investigate symptoms such as:-
You must not eat or drink for at least 4 hours before the procedure, although you may drink a small cup of water up to 2 hours before the test. You should take your regular prescription medications, unless you are otherwise advised by Mr Clarke to stop any specifically for the test.
The test is normally carried out whilst you are conscious, using either throat spray (local anaesthetic to numb the back of your throat) or a sedative injection to make you slightly drowsy. Most people tolerate it with throat spray alone, allowing quicker recovery after the procedure and return to normal. If you do have a sedative there is a longer recovery, you cannot drive, work or operate machinery for 24 hours and you would need someone to take you home and stay with you for that period too.
You will be positioned comfortably on your left side and a small mouthguard placed to protect your teeth. Once the throat spray or sedation has been given, the small telescope will be passed through your mouth and into your throat. It will not interfere with breathing. Air is passed through the telescope to give a better view, which can make you feel bloated or the need to belch. Any saliva that collects in your mouth is removed by the nurse using a sucker.
During the test a tissue sample (biopsy) may be taken for laboratory examination. This is normally painless. Sometimes a treatment such as stretching of a narrow area (dilatation) may also be performed.
The test normally takes between 5-20 minutes. If you have throat spray you cannot eat or drink for one hour after the procedure, as the local anaesthetic temporarily affects your swallowing. If you have sedation, a friend or relative should collect you and ideally stay with you for 24 hours, during which time you should not drive, work or operate machinery.
Complications are very uncommon following diagnostic endoscopy (less than 1 in 1000) but may include bleeding, perforation or a reaction to the sedative drug. If you develop difficulty swallowing, increasing abdominal or chest pain, pass black or bloody stools, have a fever or are worried, you should contact your GP or emergency department.
Mr Clarke will discuss the results with you immediately after the test and will provide a written report for you to take home. A copy will also be sent to your own GP.
I highly commend his approachable friendly manner. He made me feel at ease and informed through all aspects of my treatment and surgery.
Surgery, care and follow-up were carried out to a very high standard. I wouldn't hesitate to recommend Mr Clarke to others.
I found Mr Clarke extremely confident in this line of surgery, knowledgeable and very nice. Had a great ability to keep me at ease throughout.
Perfect from referral to discharge. Everything explained fully. Every discussion with Mr Clarke was perfectly judged.
Mr Clarke was outstanding from the start of my treatment to the end. He was empathetic, knowledgeable, respectful and made you feel at ease.
Mr Clarke was extremely efficient both in consultation and surgery. He was very caring and took time to explain procedures.I would highly recommend him.
Very pleased with outcome of op from Mr Clarke. Just like 2016 he was very helpful and so professional. Would definitely recommend.
Excellent manner both in consultation, pre- and post-op. Would definitely be happy to see him and recommend to others requiring surgery.
Mr Clarke made the whole experience a breeze. So calm, polite and understanding of patients' needs.
My introduction to Mr Clarke was met with a warm smile and a firm handshake. He was professional and friendly and put me at ease. I have no hesitation in recommending Mr Clarke.
Mr Clarke did everything he said he would. Appointments came through quickly and I was made to feel comfortable and I had confidence in Mr Clarke from the outset.
Mr Clarke has been most helpful to my specific situation. He made allowances for me and adapted to my particular health issues.
Mr Clarke could not have done more for me. He looked after me and made me feel important and safe.
Whole experience was very professional, so felt safe in his hands. Communication so important and Mr Clarke was brilliant.