Name of the Procedure:

Esophageal Balloon Distension Study (EBDS), Diagnostic, with Provocation

Summary

An Esophageal Balloon Distension Study (EBDS) is a diagnostic test that involves inflating a balloon inside the esophagus to assess how the esophagus functions and to identify any abnormalities. This procedure helps in diagnosing conditions that affect swallowing or cause chronic chest pain.

Purpose

This procedure is used to diagnose esophageal disorders, such as esophageal spasms, achalasia, or hypersensitivity in the esophagus. The primary goal is to identify abnormalities in esophageal function and structure, which can help guide treatment plans.

Indications

• Persistent chest pain of unexplained origin
• Difficulty swallowing (dysphagia)
• Gastroesophageal reflux disease (GERD) when regular tests are inconclusive
• Suspected esophageal motility disorders

Preparation

• Fasting for at least 6 hours before the procedure.
• Discontinuation of certain medications, as advised by the healthcare provider.
• Possible pre-procedure diagnostic tests, such as an esophagram or endoscopy.

Procedure Description

1. The patient is asked to lie down on an examination table.
2. Local anesthetic may be applied to the throat to minimize discomfort.
3. A thin, flexible tube (catheter) with a deflated balloon at the tip is gently inserted through the mouth and guided into the esophagus.
4. The balloon is incrementally inflated while pressure measurements are taken and the patient's symptoms are monitored.
5. The healthcare provider may provoke symptoms to observe the esophagus's response to different stimuli.
6. The balloon is then deflated and the catheter is removed.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or specialized diagnostic center.

Personnel

• Gastroenterologist or specialist in esophageal disorders
• Nurse or medical assistant
• Anesthesiologist (if sedation is used)

Risks and Complications

• Mild discomfort during insertion and inflation of the balloon
• Small risk of esophageal perforation or tearing
• Bleeding or infection
• Reaction to sedation or anesthesia, if used

Benefits

• Accurate diagnosis of esophageal conditions
• Better treatment planning for the diagnosed condition
• Relief from symptoms through appropriate intervention

Recovery

• Observation for a short period post-procedure to monitor for any immediate complications
• Normal activities can typically be resumed within a few hours
• Follow-up appointment may be scheduled to discuss results and next steps

Alternatives

• Esophageal manometry, which measures muscle contractions in the esophagus
• Upper endoscopy, to directly visualize the esophagus and take biopsies if needed
• Barium swallow radiographic examination, which highlights the esophagus using a contrast agent

Patient Experience

• The patient might feel pressure or slight discomfort during balloon inflation.
• Throat numbness or slight irritation from the local anesthetic.
• Mild discomfort or bloating post-procedure, which usually resolves quickly.
• Provision of pain management strategies and comfort measures to help ease post-procedure symptoms.