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What Is EndoFLIP?

Medically Reviewed by Mahammad Juber, MD on August 09, 2022

If you or a loved one is suffering from gastrointestinal issues, your doctor may recommend an EndoFLIP procedure. This diagnostic tool offers accurate measurements within certain areas of the gastrointestinal system, including the esophagus.

What Is an EndoFLIP Procedure?

EndoFLIP stands for endoluminal functional lumen imaging probe. This newer technology is a minimally invasive way of measuring the area inside a gastrointestinal organ and the pressure within the organ.

Doctors typically use EndoFLIPs to assess the health of the esophagus, the tube that food goes down to reach your stomach. EndoFLIPs use a sensory balloon to obtain measurements of the esophagus, which help doctors diagnose gastrointestinal issues.

How Is an EndoFlip Performed?

Doctors often perform EndoFLIP procedures alongside upper endoscopies. An endoscopy is a procedure that looks at the digestive tract. During an endoscopy, the patient is sedated or has some type of numbing medication. The doctor then slides a thin tube with a camera on the end down the esophagus, stomach, and small intestine to take a look at these areas.

EndoFLIPs are similar. These procedures often require the patient to be sedated as well. Your doctor will uses a catheter attached to a sensory balloon. They will fill the balloon with a special ionic fluid, then activate the electrodes within the balloon and along the catheter to take measurements.

Measurements taken by the EndoFLIP include the area across the esophagus and the pressure inside.  Your doctor will create a ratio of these measurements called distensibility, which measures the stiffness of your esophagus.

What Does an EndoFlip Diagnose?

EndoFLIPs are given to those with gastrointestinal problems. They may help diagnose problems such as: 

  • Achalasia
  • Dysphagia
  • Eosinophilic esophagitis
  • Esophageal atresia
  • Tracheoesophageal fistula

Achalasia. Achalasia is a disorder that makes it hard for food to pass from your esophagus into your stomach. This is due to damaged nerves within the esophagus, which causes the esophagus to eventually become paralyzed. It’s unclear why these nerves become damaged, but researchers suspect this can happen due to a viral infection or autoimmune response. Symptoms of achalasia include:

  • The inability to swallow
  • Vomiting or regurgitation
  • Heartburn
  • Chest pain
  • Belching
  • Pneumonia, caused by breathing food into the lungs
  • Weight loss

There is no cure for achalasia, but symptom management is possible.

Dysphagia. People with dysphagia have trouble swallowing. Doctors often use an EndoFLIP to figure out what may be causing dysphagia as there are many potential causes. Symptoms may include:

  • The inability to swallow or pain while swallowing
  • Coughing, gagging, or regurgitation
  • Frequent heartburn or stomach acid in the throat
  • Feeling like food is stuck in the throat
  • Hoarseness
  • Drooling
  • Weight loss

Eosinophilic Esophagitis. Eosinophilic esophagitis is swelling or inflammation of the esophagus due to an allergic reaction. It’s often caused by an allergic reaction to food.

Symptoms of eosinophilic esophagitis include: 

  • Difficulty swallowing or food stuck in throat
  • Vomiting
  • Chest pain
  • Refusing to eat, especially in young children

Esophageal atresia. Esophageal atresia is a birth defect that results in a baby’s esophagus not developing properly. There are four types of esophageal atresia: 

  • Type A. This is when the upper and lower parts of the esophagus partially develop but do not connect. Instead, each unattached end is closed off.
  • Type B. This is when the upper part of the esophagus has attached to the trachea, but does not connect to the lower part, which has a closed end. Type B is very rare.
  • Type C. This is when the lower part of the esophagus attaches to the trachea and the upper part is closed off. Type C is the most common type.
  • Type D. This is when both the upper and lower parts of the esophagus are connected to the trachea instead of each other. Type D is very severe and also the rarest type of esophageal atresia.

Researchers don’t know what causes esophageal atresia. It often occurs with other birth defects, most commonly a tracheoesophageal fistula.

Tracheoesophageal fistula. In a tracheoesophageal fistula, the esophagus and trachea are joined together rather than exist as two separate tubes, as they typically are. This is due to an error while the baby is developing in the uterus. At the beginning of development, the esophagus and trachea start as one tube. Tracheoesophageal fistulas occur when the tubes do not properly separate.

Unlike esophageal atresia, symptoms of just a tracheoesophageal fistula aren’t always immediately apparent. They may include coughing while feeding and frequent lung infections.

What are the Risks of an EndoFlip?

EndoFLIP is a relatively new procedure, and as of yet there are no known reports of severe complications. However, there are some small risks of bleeding or perforation.

As with an endoscopy, patients may feel some soreness in their throat after the procedure. Because EndoFLIPs are typically done under anesthesia, there may be some side effects of anesthesia, including:

  • Fatigue
  • Headache
  • Muscle pain
  • Nausea and vomiting
  • Sore throat

How to Prepare for an EndoFlip Procedure

Before your EndoFLIP procedure, your doctor will give you specific instructions. Generally speaking, preparing for an EndoFLIP is similar to preparing for an endoscopy. This may include:

  • A liquid diet for 24 hours before the procedure
  • Fasting the day of the procedure
  • A licensed driver to take you home after the procedure, as you will likely be groggy from the anesthesia

After your procedure, your doctor may go over your preliminary results in the recovery room.

Other Types of Gastrointestinal Procedures

Aside from an endoscopy and EndoFLIP, there are many other gastrointestinal diagnostic procedures. Depending on your symptoms and diagnosis, you may need some of these procedures in conjunction with an EndoFLIP to find the correct diagnosis and treatment plan. These may include:

  • Balloon-Assisted Endoscopy: an endoscopy using a balloon to inflate the sides of the bowel and reach farther for examination
  • Capsule Endoscopy: an endoscopy done by the patient swallowing a capsule with a camera
  • Endoscopic Ultrasound: an endoscopy with ultrasound imaging
  • Esophageal Manometry: a catheter that measures pressure on the esophagus.
  • Esophageal pH monitoring study: a test that measures acid reflux using a catheter or small capsule

Show Sources

SOURCES:

Boston Children’s Hospital: “EndoFLIP,” “Endoscopy,” “Eosinophilic Esophagitis in Children,” “Tracheoesophageal Fistula.” 

Centers for Disease Control and Prevention: “Facts about Esophageal Atresia.”

Cleveland Clinic: "Anesthesia."

Mayo Clinic: “Achalasia,” “Dysphagia.”

Stanford Medicine: “EndoFlip and EsoFlip.”

University of Michigan Health: “A Better View of Esophagus Dysfunction,” “EndoFLIP,” “Gastrointestinal Diagnostics & Procedures.”

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