Gastroenterological functional laboratory

How does it work?

Conventional endoscopic procedures can only capture small parts of the small intestine; around 80% of the small intestine cannot be assessed using endoscopic procedures. Capsule endoscopy consists of a miniature camera in capsule form that is swallowed and can record images of the small intestine along the way, which are sent to a receiver that the patient carries with them. The images are processed into a film that enables the entire mucous membrane of the small intestine to be assessed.

When is the examination useful?

Capsule endoscopy is useful for suspected diseases of the small intestine that cannot be examined using other endoscopic procedures. These include, for example

• Bleeding from the small intestine
• Infestation of the small intestine in Crohn's disease
• Suspected drug-induced lesions of the small intestine (e.g. caused by painkillers)
• Suspected tumour diseases of the small intestine

What needs to be considered before the test?

• Please ask our specialist staff (phone number above) for instructions on bowel preparation for capsule endoscopy.

How does it work?

• Please arrive punctually for the capsule endoscopy at the agreed time in loose-fitting, two-piece clothing.
• During the endoscopy, a measuring belt or probes will be attached to your abdomen with adhesive pads and connected to a recording device, which you will wear on another belt around your waist. You will then be instructed to take the capsule
• After taking the capsule, you must not eat or drink anything for 2 hours. After 2 hours you can drink water, after 4 hours you can have a light snack. Once the examination is complete, you can return to your normal diet.
• The capsule endoscopy lasts 14 hours. During this time, you must not remove the belt or the probes under any circumstances.
• Return all equipment to your doctor's surgery or hospital as soon as possible.
• The capsule is a disposable item and is excreted naturally through bowel movements. Please note whether the capsule has been excreted.

Information on the examination and planning via our endoscopy consultation Endoscopy Outpatient Clinic (END1)

How does it work?

The intraluminal pressures in the oesophagus are measured simultaneously during standardised swallowing acts. The measurement data can be used to draw conclusions about the peristaltic sequence and coordination of the tubular oesophagus and the adjacent sphincters.

When is the examination useful?

• Clarification of non-cardiac thoracic pain
• Clarification of unclear dysphagia
• Primary motility disorders (achalasia, diffuse oesophageal spasm ...)
• V.a. secondary motility disorder
• Motility disorders in the context of systemic diseases

What must be observed before the test?

• At least 8 -10 h fasting before the test
• No motility-influencing medication for 48 h before the test e.g. Ca antagonists, nitrates, prokinetics, anticholinergics, beta-blockers, theophylline, benzodiazepines, opiates - as far as medically justifiable!

How does it work?

Duration: approx. ½ hour
Placement of the probe into the stomach. Measurement of the pressures in the area of the lower oesophageal sphincter, the tubular oesophagus and the upper sphincter during 10 wet swallows in a lying position and 5 wet swallows in a sitting position. The tube is removed immediately afterwards.
Information on the examination and planning via our endoscopy consultation Endoscopy Outpatient Clinic (END1)

How does it work?

Using a combined impedance and pH measuring probe in the oesophagus, the number, duration and extent of acid gastro-oesophageal refluxes can be continuously determined. The correlation to activities, symptoms and medication intake allows an exact allocation to these events. Simultaneous impedance measurement in the oesophagus allows the diagnosis of reflux disease or reflux-related illnesses. Impedance is used to measure the electrical conductivity of an organ and its contents. The measured values are recorded on a digital data carrier, which is read out by a computer at the end of the examination.

When is the examination useful

Reflux disease (suspected)

• with typical symptoms, but without gastroscopic signs
• before or after surgical treatment (fundoplication)
• Therapy monitoring for refractory reflux oesophagitis under acid suppression

• for atypical complaints such as laryngitis, recurrent or persistent hoarseness,
• Clarification of unclear chest pain, unclear bronchopulmonary diseases

What must be observed before the test?

• Fasting for approx. 6 - 8 hours before the test
• No acid-suppressive therapy (except for therapy control)
• No antacids at least 24 hours before, no H2 receptor antagonists 48 hours before, no proton pump inhibitors for at least 3 days (overlapping therapy with antacids if necessary)
• No motility-influencing medication for 48 hours before the examination (as far as medically justifiable)

How does it work?

Duration: ½ h in the laboratory for calibration and placement of the probe, 24 h measurement with probe and device at the usual place of work/residence/inpatient ward

After calibration of the device, the combined impedance/pH-metry probe is first placed in the stomach via the nose, then the probe is slowly withdrawn (pH jump) to 5 cm above the lower oesophageal sphincter. The patient is given a documentation protocol for complaints, activity and medication.
Information on the examination and planning via our endoscopy consultationEndoscopy outpatient clinic (END1)

How does it work?

In healthy people, lactose is broken down in the small intestine by lactase and completely absorbed within the small intestine. If there is a lactase deficiency, the lactose is metabolised by bacteria after reaching the large intestine to form H2, which appears in the exhaled air.

When is the test useful?

• Suspicion of lactose intolerance

What must be observed before the test?

• At least 12 hours fasting and no smoking
• No antibiotics
• No carbohydrate-rich meals the day before (e.g. beans, wholemeal bread, pasta, rice, potatoes)

Further information on preparation

How does it work?
Duration: approx. 3 1/2 to 4 1/2 hours

At the beginning, the 1st breath sample (initial value) is taken, then 25 g of lactose in 200 ml of non-carbonated mineral water or tea is drunk. After 20, 40, 60, 80, 100, 120, 140, 160, 180 up to a maximum of 240 minutes, further breath samples are taken to determine the H2 concentration in the exhaled air.

How does it work?

The human intestine can neither break down nor absorb lactulose. It is metabolised by intestinal bacteria (mainly in the cecum) to H2, which appears in the exhaled air.

When is the test useful?

• Exclusion of an H2 non-producer
• Determination of the oro-caecal transit time

What must be observed before the test?

• Fasting for at least 12 hours and no smoking
• No antibiotics
• No carbohydrate-rich meals the day before (e.g. beans, wholemeal bread, pasta, rice, potatoes)

Further information on preparation

How does it work?
Duration: approx. 4 1/2 hours

At the beginning, the 1st breath sample (initial value) is taken, then 10 g of lactulose is drunk in 200 ml of non-carbonated mineral water or tea. After 20, 40, 60, 80, 100, 120, 140, 160, 180, 200, 220 and 240 minutes, further breath samples are taken to determine the H2 concentration in the exhaled air.

How does it work?

Glucose is normally completely absorbed enterally. If there is a faulty colonisation in the proximal gastrointestinal tract, H2 is formed through the metabolisation of glucose by bacteria, which appears in the exhaled air

When is the test useful?

To clarify meteorism, flatulence, postprandial bloating

What must be observed before the test?

• Fasting for at least 12 hours and no smoking
• No antibiotics, no carbohydrate-rich meals the day before

Further information on preparation

How does it work?
Duration: approx. 3½ hours

At the beginning, the 1st breath sample (baseline value) is obtained, then 75 g glucose is drunk in 200 ml non-carbonated mineral water or tea. After 20, 40, 60, 80, 100, 120, 140, 160 and 180 minutes, further breath samples are taken to determine the H2 concentration in the exhaled air.

How does it work?

Fructose is normally completely absorbed enterally. In the presence of fructose malabsorption in the proximal gastrointestinal tract, H2 is formed by the metabolisation of fructose by bacteria, which appears in the exhaled air.

When is the examination useful?

To clarify meteorism, flatulence, diarrhoea

What must be observed before the test?

• Fasting for at least 12 hours and no smoking
• No antibiotics, no carbohydrate-rich meals the day before

Further information on preparation

How does it work?
Duration: approx. 3 1/2 to 4 1/2 hours

At the beginning, the 1st breath sample (initial value) is taken, then 25 g of fructose in 200 ml of tea is drunk. After 20, 40, 60, 80, 100, 120, 140, 160 and 180 to a maximum of 240 minutes, further breath samples are taken to determine the H2 concentration in the exhaled air.