Diagnostic Testing & Treatments

Turn to experienced providers at the Digestive Health Institute for preventive screenings, advanced diagnostic tests and procedures, and ongoing treatments for whole gastrointestinal system health. When you work with us, you’ll get an accurate diagnosis so you can get the right treatment for your condition.

Diagnosis

Digestive Health Tests

The Digestive Health Institute offers a broad range of diagnostic tests and procedures, including:

• Abdominal ultrasound. A non-invasive test, this helps us see the liver, gallbladder, kidneys and other organs in the abdomen.
• Anorectal manometry. If you have constipation or fecal incontinence, this can measure how well the rectum and anal sphincter are working.
• Anoscopy. This high-resolution approach helps us examine the anal canal and rectum for abnormalities, precancerous changes and early-stage cancers.
• Antroduodenal manometry. We use this technology to measure muscle food movement in the lower stomach and beginning of the small intestine.
• Breath testings. We test the air you exhale to diagnose bacterial overgrowth, lactose intolerance and other malabsorption issues.
• Colonic motility testing. Manometry helps us check the ability of your colon to contract its muscles and move food through effectively.
• Colonoscopy. Using a scope inserted into the rectum, we examine the lining of your large intestine, colon and rectum for polyps, cancer and other abnormalities.
• CT scan and MRI. We use this non-invasive technology to collect detailed views of the abdominal organs and identify tumors, cysts or blockages.
• Endoscopic retrograde cholangiopancreatography (ERCP). This test combines endoscopy and X-ray to examine your gallbladder, liver pancreas and bile ducts. We can also treat bile or pancreatic duct issues and remove gallstones or stents.
• Endoscopic ultrasound (EUS). Combining the tactics of endoscopy and ultrasound, we can assess deeper tissue and structures in your digestive tract. It’s often used to look at the pancreas, bile ducts and surrounding organs.
• Endoscopy. A scope sent down the throat captures images of your digestive tract. There are several types, including:
  • Capsule endoscopy. Instead of inserting a scope during a procedure, this is a pill you swallow that takes images of your small intestine as it passes naturally through your system
  • Spiral enteroscopy. Using a thin, flexible scope, we can take images of your small intestines and even treat some conditions.
  • Upper endoscopy (EGD). We take images and biopsies of the esophagus, stomach and the upper portion of your small intestines to diagnose certain conditions.
• Esophageal manometry. A swallowing test to determine if your esophagus can move food to your stomach properly.
• Esophageal pH Testing/BRAVO. This measures the acid (pH) levels in your esophagus to determine if you have gastroesophageal reflux disease (GERD) or other related conditions.
• H. Pylori testing. A way to detect the presence of this bacteria, which can cause ulcers and gastritis.
• Impedance planimetry (endoFLIP). Endoluminal functional lumen imaging probe is a minimally invasive way for us to check the esophagus using a sensory balloon that measures pressure and area.
• Liver biopsy. A specialist will remove a small sample of tissue from the liver to diagnose or monitor liver disease.
• Paracentesis. If liver disease or another condition causes your body to collect fluids in the abdomen, this can be used to drain it.
• Sigmoidoscopy. The test focuses on the rectum and sigmoid colon to detect abnormalities and screen for colon cancer.
• Stool tests. Submitting stool samples helps us assess your digestive health and screen for infections, inflammation and blood.

Treatments and Surgical Procedures

The following is a noncomprehensive list of treatments and surgical procedures available through the Digestive Health Institute.

• Anti-reflux surgery. There are several types of anti-reflux surgery to ease acid reflux for patients with GERD, including: fundoplication, in which the surgeon wraps the top of the stomach around the lower esophageal sphincter to tighten the muscle; implantation of a LINX device around the junction of the stomach and esophagus to prevent refluxing acid from backing up; and transoral incisionless fundoplication (TIF), in which the surgeon goes through the mouth to create a partial wrap around the lower esophagus.
• Abdominoperineal resection. This surgery for rectal or anal cancer involves removing the anus, rectum and some or all of the sigmoid colon.
• Bariatric surgery. Our skilled team offers several surgical options for weight loss, including Roux-en-Y gastric bypass, sleeve gastrectomy and adjustable gastric band.
• Biliary stenting. To relieve a blockage or treat a leak, we may insert a special tube to keep the bile duct open.
• Biofeedback therapy. Some patients find relief through this therapy which enables them to learn to influence their bodily functions with the help of machinery. Patients with fecal incontinence, IBS and constipation have found it helpful.
• Bowel resection. To help treat conditions like Crohn’s disease, diverticulosis, cancer or blockages, we may need to remove a portion of the small or large intestine and reconnect or resect the new edges to allow food to pass.
• Cholecystectomy. The medical term for surgical removal of the gallbladder. 
• Electrohydraulic Lithotripsy (EHL). We use targeted shockwaves to break up kidney stones and gallstones. We can also use EHL for fragmentation of bile and pancreatic duct stones during endoscopy.
• Endoscopic Retrograde Cholangiopancreatography (ERCP). By using both endoscopy and X-ray technology, we can watch special medical dye travel through your pancreatic and bile ducts and identify any issues like gallstones, tumors or strictures.
• Endoscopic Submucosal Dissection (ESD). This is a minimally invasive procedure to remove precancerous and cancerous areas in the digestive tract, especially in patients with Barrett’s esophagus, cancer and tumors in the esophagus.
• Endoscopic ultrasound-directed transgastric ERCP (EDGE). An outpatient procedure that allows us to diagnose and treat bile duct, pancreas and gallbladder issues after a patient has had gastric bypass surgery.
• Enterra therapy™. A form of gastric electrical stimulation, Enterra is an implantable device that your specialist will program to deliver mild electrical pulses to treat the chronic nausea and vomiting of gastroparesis. The neurostimulator is implanted beneath the skin of the lower abdomen and two leads are implanted in the stomach wall to deliver the pulses.
• Esophageal dilation. If your condition has caused narrowing of the esophagus, called strictures, you many have trouble swallowing. We can go in with an endoscopy scope and widen the area to help.
• Gastric peroral endoscopic myotomy (POEM). A procedure addressing slow stomach emptying as a result of muscle dysfunction due to gastroparesis. Using an endoscope, your specialist will create a tunnel in the stomach wall and cut the muscle at the end of the stomach.
• Gastrostomy tube (g-tube) placement. If your condition doesn’t allow you to eat enough food by mouth, your provider may recommend a g-tube to bring nutrition directly into the stomach. The tube is surgically inserted through the skin on your stomach while the surgeon monitors placement with an endoscope.
• Hartmann’s Procedure. Surgery to remove part of the colon and sometimes the rectum. The remaining rectum is sealed to create a pouch while the remaining colon is directed to a colostomy.
• Hemorrhoid banding. Also known as rubber band ligation, this is a non-surgical treatment for hemorrhoids. A rubber band is applied to the hemorrhoid using a special scope, cutting off its blood supply and causing it to shrink and eventually fall off.
• Hemorrhoidectomy. Your specialist will surgically remove the hemorrhoids and seal the blood vessels connected to them.
• Ileoanal anastomosis. Your specialist will remove the large intestine and make a pouch inside the body called a J pouch to allow you to get rid of stool.
• Ileostomy/colostomy. Two forms of ostomy surgery to reroute a piece of intestine through the abdominal wall to the skin of the abdomen where an ostomy bag is attached to collect stool. Colostomy uses a piece of the intestine while ileostomy uses a piece of the small intestine. These procedures can be necessary if you have bowel cancer or an obstruction, Crohn’s disease or ulcerative colitis.
• Liver biopsy. A specialist will use a hollow needle to remove/biopsy a small tissue sample from the liver for a pathologist to examine for signs of your liver’s health. 
• Liver resection. We’ll use this surgical procedure to remove part of all of the liver if you have tumors. The liver will regenerate itself.
• Liver transplant. Transplant specialists at Hartford HealthCare can surgically remove a diseased or failing liver and replace it with a healthy donated liver.
• Pancreatectomy. Surgical removal of the pancreas in cases of pancreatic tumors or cancer. In a total pancreatectomy, we’ll also remove the gallbladder, distal stomach, some of the small intestine, spleen and associated lymph nodes.
• Paracentesis. A procedure that drains fluid from the abdomen using a needle, often in patients with liver disease.
• Pelvic floor rehabilitation. Specially trained physical therapists work with patients to assess and treat the muscles, ligaments and connective tissues in the pelvic region to promote bowel function and relieve constipation and incontinence.
• Pneumatic dilation. Your specialist will insert an endoscopic tube through the mouth and into the esophagus where a balloon will be expanded to stretch the muscles of the lower esophageal sphincter, which can become too tight in people with achalasia.
• Polypectomy. Done during a colonoscopy, this is the surgical removal of polyps to prevent them from becoming cancerous.
• Proctocolectomy. A surgical procedure to remove part or all of your colon and rectum in patients with inflammatory bowel disease, diverticulitis, severe constipation or colorectal cancer.
• Radiofrequency ablation (RFA). High-energy radio waves can be used to destroy pre-cancerous cells found in the esophagus and abnormal tissue resulting from Barrett’s esophagus.
• Rebyota®. A live microbiota-based product we use to prevent recurrence of clostridioides difficile (C.diff) infection.
• Sphincterotomy. We’ll use this surgical procedure in patients with anal fissures or bile duct stones. An incision in the sphincter muscle eases the pressure that is preventing healing and helps increase blood flow to the area to help you heal.
• Sphincter-sparing surgery. If a tumor does not involve the sphincter muscle or pelvic floor, we can perform sphincter-sparing surgery to preserve the sphincter muscles and anus while removing the colon or rectum. This allows patients control over bowel movements.
• Spiral enteroscopy. This minimally invasive technique allows us to perform procedures in the small bowel and examine this section of the gastrointestinal tract. It’s a form of endoscopy using a thin, flexible scope that takes video images of the small intestine.
• Strictureplasty. When chronic inflammation from Crohn’s disease and ulcerative colitis cause strictures, or tightening in the intestines, this surgery can widen the areas, relieving pain and other symptoms.
• Whipple procedure. Surgery to remove the head of the pancreas, first part of the small intestine, gallbladder and bile duct in patients with pancreatic cancer, pancreatitis or other conditions. This is also called a pancreaticoduodenectomy. Remaining organs are rejoined so food can still be digested.