Endoflip

Overview

EndoFLIP is a specialised test that uses a thin, flexible tube with a small balloon to measure how your esophagus works. Your esophagus is the food pipe that carries food from your mouth to your stomach. The test checks how well the esophagus squeezes, relaxes, and stretches. It is not a treatment and it does not diagnose a condition by itself. It gives your specialist detailed information about how your esophagus is working.

EndoFLIP is not a routine test. It is used in selected people when standard tests do not give enough information about how the esophagus is working.

It can be used in adults and sometimes in children at specialist centres. It is most often considered for people with difficulty swallowing, food sticking, chest pain with swallowing, or suspected problems with the esophagus muscle or valve.

Symptoms

Common symptoms

• Difficulty swallowing solid foods or liquids
• A feeling that food sticks or gets stuck in the chest or throat
• Chest pain or discomfort when swallowing
• Regurgitation, where food or liquid comes back up
• Heartburn or reflux that does not settle with usual care
• Unexplained weight loss because eating is difficult
• Coughing or choking while eating or drinking

Symptoms in children

• Poor feeding or slow feeding
• Coughing, choking, or gagging during feeds
• Vomiting or bringing food back up
• Trouble gaining weight
• Complaining of chest or throat discomfort with eating

Symptoms in older adults

• New or worsening trouble swallowing
• Food sticking or eating very slowly
• Weight loss or poor appetite
• Coughing after meals or repeated chest infections
• Chest pain or reflux symptoms

Causes

Main causes

• EndoFLIP is a test, not a disease, so it does not have causes. It is used to assess conditions such as achalasia, where the lower esophagus valve does not relax properly.
• It can also assess esophageal spasm, which is painful, uncoordinated squeezing of the esophagus.
• Other reasons include reflux-related damage or narrowing, problems after esophagus surgery, and other disorders of the esophagus muscle or valve.

Risk factors

• Long-standing heartburn or reflux
• A connective tissue disorder
• Certain nerve or muscle disorders
• Previous surgery or injury to the esophagus
• Family history of esophagus motility problems
• Smoking or heavy alcohol use, which can irritate the esophagus
• Age — motility problems become more common with age

When to see a doctor

See a doctor urgently if:

• You cannot swallow liquids or saliva
• You have severe chest pain or pain with breathing
• You are vomiting blood or have black stools
• You have fever, severe pain, or trouble breathing after a procedure
• Swallowing is getting worse quickly
• You have signs of dehydration

Book a routine appointment if:

• You have had trouble swallowing for more than a few weeks
• Food feels like it sticks but passes
• Heartburn or reflux continues despite lifestyle changes
• You have unexplained coughing or choking with meals
• Your doctor has suggested EndoFLIP and you have questions

Diagnosis

EndoFLIP is not a diagnosis in itself. It is one part of an assessment. A specialist doctor will ask about your symptoms, examine you, and may arrange other tests first. EndoFLIP is used when more detail is needed about how the esophagus moves and stretches.

Tests that may be done

• Endoscopy, a camera test to look inside the esophagus and stomach
• Esophageal manometry, a test that measures pressure and muscle contractions
• Barium swallow, X-ray pictures taken while you swallow a liquid
• pH monitoring, a test that measures acid reflux
• EndoFLIP, a balloon test to measure how the esophagus opens and stretches
• Blood tests or other tests to look for other causes

What to expect at your appointment

You will usually be asked not to eat or drink for several hours before the test. The team may use a numbing spray or sedation to keep you comfortable. A thin tube is passed through your nose or mouth into your esophagus. A small balloon inflates gently while sensors measure pressure, width, and stretch. It usually takes about 15 to 30 minutes. You may have a sore throat or mild chest discomfort afterwards. If you had sedation, arrange for someone to take you home.

Treatment

EndoFLIP does not treat the esophagus. It helps your specialist understand what is happening so they can recommend the right care. Treatment depends on the findings and may include lifestyle changes, medicines, procedures, or surgery.

Self-care at home

• Follow the fasting instructions exactly
• Tell the team about allergies, medicines, and health conditions
• Arrange a ride home if you will have sedation
• Rest for the day if you feel sleepy after sedation
• Sip fluids gently and eat soft foods if your throat is sore
• Report severe pain, fever, vomiting blood, or trouble breathing right away

Medical treatments

Treatment is tailored to the cause. It may include changes to how and what you eat, medicines that reduce stomach acid or help the esophagus muscle relax, swallowing therapy, or procedures to stretch or widen a tight area. Your specialist will explain the options and the benefits and risks.

When is surgery considered?

If tests show a problem such as a tight valve that does not relax or a structural issue, surgery or an endoscopic procedure may be considered. EndoFLIP can help the team plan the procedure and check the result. Your specialist will discuss whether this is right for you.

Living with this condition

If you have a swallowing condition, eating can take more time and planning. Eat slowly, chew well, and take small bites. Sit upright during meals and stay upright for a while afterwards. Follow your care plan and keep track of symptoms that get worse.

Lifestyle tips

• Avoid foods that trigger symptoms, such as very dry, tough, or spicy foods if they cause pain
• Limit alcohol and stop smoking
• Manage reflux by avoiding late meals and large meals
• Raise the head of your bed if night reflux is a problem
• Keep a symptom diary to share with your doctor

Diet and exercise

If swallowing is difficult, choose soft, moist foods and take small sips of liquid with meals. Ask for a referral to a dietitian if you are losing weight or finding it hard to eat enough. Gentle regular activity supports digestion and overall health. Avoid strenuous exercise right after a procedure until your team says it is safe.

Mental health and emotional wellbeing

Swallowing problems can be worrying and can affect eating with others, sleep, and mood. It is normal to feel anxious or frustrated. Talk to your doctor about how you feel. If you feel you may harm yourself or are in crisis, contact your local emergency number or a local crisis service right away.

Prevention

EndoFLIP is a test, so it cannot be prevented. Some underlying swallowing problems may be linked to long-standing reflux or lifestyle factors. Managing reflux, not smoking, and limiting alcohol may support esophagus health.

Vaccines

There is no vaccine for EndoFLIP or for most esophagus motility problems.

Screening programmes

There is no routine screening test for esophagus motility problems. EndoFLIP is used when symptoms or other tests suggest a problem.

Complications

If left untreated

• Long-standing swallowing problems can lead to poor nutrition, weight loss, or dehydration
• Food can get stuck in the esophagus, which may need urgent care
• Food or liquid can enter the airways and cause pneumonia
• Some esophagus conditions can get worse over time and make eating harder
• Rarely, severe chest pain or bleeding needs urgent care

Long-term outlook

Most swallowing conditions can be managed once the cause is clear. EndoFLIP gives detailed information that helps your team choose the right treatment. Many people improve with lifestyle changes, medicines, or procedures. Your care team will support you step by step.

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