Endoscopy is a medical procedure that helps physicians to look inside the esophagus, stomach, duodenum (first part of the small intestine) and colon with an instrument called an endoscope. Endoscopy can be used to determine the cause of symptoms, evaluate and treat some conditions/diseases in the GI tract, bile duct and pancreas. 

With endoscopy, physicians can see abnormalities, like inflammation or bleeding, through the endoscope that does not show up well on x-rays. The physician can also insert instruments into the scope to remove samples of tissue (biopsy) for further tests or treat bleeding abnormalities. 

Two tests, in particular, that are performed with the endoscopic procedure include pancreatic and biliary manometry and esophageal manometry or esophageal motility. 

Esophageal Manometry Esophageal Motility 

Esophageal manometry is an endoscopic procedure used to determine how well the muscles of the esophagus work when diseases of the muscle are suspected. The test actually records the muscle pressures within the esophagus and evaluates the action of the muscles. 

Endoscopic Ultrasound

Endoscopic ultrasound (EUS) combines the local proximity of endoscopy with the deep tissue visualizing capability of ultrasound to obtain detailed information of the digestive tract, surrounding tissue, and organs. EUS is most commonly utilized for staging cancers of the upper GI tract in addition to diagnosing chronic pancreatitis.

Endoscopic ultrasound uses an ultrasonic transducer attached to an endoscope to measure the proximity and density of tissues in the GI tract and adjacent anatomical structures within the abdomen. EUS can further equipped to sample tissue during the procedure via US-guided fine needle aspiration (FNA).

EUS uses sound waves higher than those used for conventional, trans-abdominal ultrasound. Higher frequency yields better image definition but lower penetration, requiring transducer placement closer to the anatomy of interest. The result of higher frequency imaging is greater accuracy in determining the depth of local invasion, or tumor staging. To date, EUS has demonstrated superior clinical results primarily for imaging of the upper gastrointestinal tract.