Gastrointestinal Investigation Lab

Investigations may be requested by any medical practitioners without a consultation by Dr Michael Merrett (eg; dieticians and GP’s).

Patients may also refer themselves for breath testing as a referral is not always necessary.

Investigations performed at the Gastrointestinal Lab are as follows:

Carbohydrate Breath Testing – lactose, fructose, SIBO – lactulose

Carbohydrate malabsorption can cause a variety of symptoms including abdominal bloating, pain, wind and altered bowel habits (diarrhoea and/or constipation).

When these carbohydrates are not absorbed they travel to the large intestine where bacteria that live in the large bowel use them as a food source.  The bacteria produce hydrogen and methane gas and this excess gas in the bowel can cause symptoms of irritable bowel syndrome.

The gas is carried to the lungs and exhaled it can be measured by a breath hydrogen and methane analyser.  If there is a significant rise in either gas it can indicate malabsorption.

Fructose malabsorption is a condition which results from an impaired ability to absorb dietary fructose, a sugar found in some fruit, vegetable and wheat.

Lactose intolerance is usually caused by the body’s inability to breakdown lactose which is the sugar found in dairy products.

In people with irritable bowel syndrome, malabsorption may make their symptoms worse and occur more often.   If we can identify and remove the problem foods from the diet the symptoms may improve.

For breath testing you will need to have ceased your antibiotics and probiotics 2 weeks prior to your first appointment.   The day prior you must follow a restricted diet to avoid a false result.

You will also fast for 12 hours prior to your appointment.

Appointments are booked at 8.30 in the morning and can take up to 3 hours.

There is no rebate on these tests.

Oesophageal Studies – 24 hour pH / Impedance and Oesophageal Motility

A doctor will refer patients for oesophageal physiology studies.  This usually includes manometry and 24hr pH monitoring.

Manometry

Oeosophageal manometry is performed to investigate problems such as difficulty in swallowing, chronic heartburn, reflux, chest pain, chronic cough or asthma.

How is the procedure performed?

Your nose and throat will be sprayed with local anaesthetic to reduce any discomfort.   A small tube is passed through your nose into the stomach.

You will be given water to swallow with the tube in place and oesophageal function will be measured.

You are awake during the procedure and able to talk, breathe and swallow in ease.

Preparation for Manometry

You must fast for 3 hours prior to your appointment.

You are not given any sedation and will be awake for the procedure – you are able to drive to and from the appointments.

Allow for 1 hour for the procedure.

24Hr pH Studies

This test allows us to measure the acid levels in the oesophagus over a 24hr period.

This is performed to determine:

• If excessive acid is present
• If your symptoms are due to acid reflux

How is it performed?

Your nose and throat will be sprayed with local anaesthetic to reduce any discomfort.

A small tube is passed through your nose into the oesophagus and connected to a recording device which you will wear for 24 hours.   Once the tube is in place you are able to eat and drink normally.

The recorder can be worn over your shoulder or secured to your belt.

You will return to our rooms after 24 hours to have the tube removed.

Preparation for 24hr pH studies.

You must fast for 3 hours prior to your appointment.

You may have to cease some medications prior, this will be explained when your appointment is made.

You are able to to shower or bath whilst wearing the pH equipment.

This procedure incurs a rebate from medicare.

Capsule Endoscopy

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Capsule endoscopy 

Capsule endoscopy is a procedure that uses a tiny wireless camera to take pictures of your digestive tract. A capsule endoscopy camera sits inside a vitamin-size capsule you swallow. As the capsule travels through your digestive tract, the camera takes thousands of pictures that are transmitted to a recorder you wear on a belt around your waist.

Capsule endoscopy helps doctors see inside your small intestine — an area that isn’t easily reached with more-traditional endoscopy procedures. Traditional endoscopy involves passing a long, flexible tube equipped with a video camera down your throat or through your rectum.

This procedure has an item number attached to it so that there is a medicare rebate.  You will require a referral from your specialist or GP to have this procedure.