In-Office Procedures

This noninvasive, pain-free test is used to measure liver scarring, or fibrosis, caused by a number of liver diseases, including hepatitis B and C, cirrhosis, alcoholic liver disease, and nonalcoholic fatty liver disease. Liver scarring is determined by the “stiffness” of the liver. FibroScan® is a faster, easier, and less expensive alternative to painful biopsies and is similar to an ultrasound.

You should not eat or drink (except water) for three hours prior to the test. A technician places a probe on your right side, near where the liver is located. The probe sends a painless vibration through your body into your liver. The probe measures how long it takes the vibration to travel through the liver. The faster the vibration travels through the liver, the stiffer the liver is.

The liver’s stiffness helps your physician determine the best course of treatment for you. The stiffer the liver, the more likely you have scarring, and the more rigorous treatment required. In most instances, the test only takes 10-15 minutes.

The hydrogen breath test is used to detect a patient’s failure to digest lactose, the sugar found in milk. This occurs when your body does not produce enough lactase, one of the enzymes produced by the small intestine that is important for the digestion of lactose. Symptoms of lactose intolerance include gas, bloating, cramping, or diarrhea after the consumption of dairy products.

You will need to fast for 12 hours prior to the test and avoid eating high-fiber foods the day prior. For the test, you will drink a small amount of a test sugar, usually milk, regular soda, sugar water, or lactulose. Over a 3-hour period you will provide breath samples every 20 minutes to measure the amount of hydrogen present in your breath.

Small amounts of bacteria in the intestine are normal. However, significant increases in bacteria can lead to improper absorption of nutrients. Bacterial overgrowth can result from taking certain medications or from slow passage of food through the bowels. Symptoms can include bloating, gas, diarrhea, and abdominal pain.

Bacterial overgrowth is detected by performing a hydrogen breath test, which is also conducted to test for lactose intolerance. See above for a description of the test.

This test is used to identify an active Helicobacter pylori (H. pylori) infection in the stomach or duodenum (the first part of the small intestine). If left untreated, H. pylori can cause gastric ulcers or gastritis (irritation of the stomach lining). Accurate and early detection of H. pylori can prevent the development of more severe gastrointestinal issues.

You should not eat or drink anything four hours before the test. After an initial breath sample is taken, you will drink a small amount of Pranactin®-Citric, a solution of urea and a non-radioactive carbon isotope. We will collect another breath sample 20 minutes later to test for urease, an enzyme that breaks urea down into carbon dioxide and ammonia. If these gases are detected in your breath, it indicates the presence of H. pylori.

SmartPill™ is an ingestible capsule that measures pressure, pH, and temperature as it travels through the gastrointestinal (GI) tract to assess motility. It is used to evaluate motility disorders like gastroparesis (a condition in which the contents of the stomach empty too slowly) and chronic constipation.

Your doctor might recommend this test if you have unexplained stomach problems, such as nausea, bloating, constipation, chronic abdominal pain or vomiting – all of which are symptoms of gastroparesis.

When you come for your appointment, you will eat a SmartPill™ meal bar and then swallow the SmartPill motility capsule. You will fast for six hours and then resume your normal daily activities. Over the course of 3 to 5 days, the capsule will pass through your system.

During this time, you will wear a recorder at all times except when bathing and sleeping. The recorder receives the data from the capsule. When you come back to our office to return the recorder, we will download the data and your doctor will analyze it.