Physiological Investigations


Oesophageal Studies

  • High Resolution Oesophageal Manometry
  • High Resolution Oesophageal Manometry with Rumination Method
  • 24hr ambulatory pH monitoring
  • 24hrpH/impedance monitoring
  • 96hr BRAVO pH wireless monitoring

These studies can be used to investigate disorders of swallowing, heartburn, regurgitation, rumination syndrome (symptoms of regurgitation shortly after meals), non-cardiac chest pain and persistent cough. The tests involve passing a small catheter through the nose and into the stomach using a short acting topical anaesthetic. Some tests involve going home with such a catheter in place, attached to a small data recorder. The patient returns the following day to have the tube removed and to transfer the data to a computer for analysis.   For further information, please see following leaflets:  Oesophageal Manometry,  24 hour ambulatory pH monitoring.

Anorectal Studies

  • 3D – Vector Volume Manometry
  • Reflexes and sensation
  • Neurophysiology – Pudendal Nerve Conduction and Anismus studies
  • Endo-anal Ultrasound
  • Biofeedback (Bowel retraining) for anismus (the pelvic floor failing to relax) and rectoceles.
  • Biofeedback / bowel retraining for idiopathic constipation / slow transit.
  • Rectal irrigation – introduction to a home based therapy system for some types of defaecatory disorder.

These studies can be used for the investigation of ano-rectal disorders such as faecal incontinence, constipation, defaecatory disorders and as a precursor to some surgical procedures. The tests mainly involve passing a small diameter probe into the anal canal to measure pressures, sensation and/or muscle structure. Biofeedback (bowel retraining) and rectal irrigation are therapies designed to improve/control bowel emptying. For further information, please see following leaflets: Anorectal physiology tests, Biofeedback and bowel retraining.


  • Cystometry/flow studies
  • Ambulatory studies
  • Bladder Ultrasound for residual urine
  • Video Urodynamics

These studies can be used for the investigation of bladder problems such as urine incontinence, difficulty with urination, recurrent infection and as a precursor to some surgical procedures. The tests generally involve passing a small catheter into the bladder, and an equally small one into the rectum, so pressures can be measured both inside and outside the bladder. The bladder is then gently filled with sterile saline solution whilst bladder pressures are monitored.  For further information, please see following leaflets: Adult Urodynamic bladder and urinary tract tests & investigations,  Ambulatory urodynamic tests,  Children’s Urodynamic Bladder and urinary tract tests and investigations.

Test Conditions

All of the above studies are conducted in quiet, secluded surroundings in a sympathetic and understanding manner by specially trained,  qualified and accredited staff. Great care is taken to make the patient feel at ease, and to minimize any discomfort caused by the test procedure. Except for the oesophageal studies, anaesthetics are rarely necessary and sedation is not used; patients can drive etc. immediately after having their tests performed.

Specific Instructions

Some of the above tests require that the patient follow specific instructions with regard to diet and medication. These instructions will be included with the appointment letter. Please take the time to read them carefully (for example you may need to stop certain medications for several days before the test). If you fail to follow the instructions we may not be able tp proceed with the test. This causes delays for you and other patients. If any of the test conditions pose a particular problem, please get in touch with the Unit well before your appointment date so we can do our best to accommodate your needs.