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Diagnostic Services

Advanced diagnostic tools for voice and swallowing disorders

If you’ve struggled with swallowing, speaking, chronic cough, or other problems within your throat, then you know how important it is to undergo proper treatment — a plan tailored to your individual needs can help restore your quality of life. First, though, it’s critical that your particular medical condition or disorder is correctly diagnosed.

Diagnosing motility disorders

“Motility” is a technical term that refers to the way in which food and liquid is propelled from your throat to your stomach, and then through the rest of your digestive tract, via a series of muscle contractions. If these muscles, called sphincters, aren’t working properly, you may have what doctors call an esophageal motility disorder.

Clinicians at the Ronny Schwartz Center for Voice, Swallowing and Motility Disorders specialize in diagnosing motility disorders within the esophagus, which is the tube that connects your throat to your stomach.

If you often find yourself gagging, choking, or having trouble swallowing, you may have a motility problem in your upper esophagus. If the sphincter muscles in the lower part of your esophagus aren’t functioning normally, stomach acid can flow backwards up through your esophagus, causing acid reflux (also known as GERD), heartburn or chronic coughing.

Working closely with gastroenterologists who specialize in motility disorders, our team can evaluate your symptoms with a variety of sophisticated tests including wireless pH testing and high-resolution esophageal manometry. These tools provide our doctors with objective data that allow them to make a more precise diagnosis — for example, if you’ve had trouble swallowing, your doctor could distinguish whether the dysfunction is occurring in your throat, which may require one course of treatment, versus a problem in your esophagus that requires a much different kind of treatment.

If your condition does not require voice, swallowing, speech or other types of licensed therapy offered at the Ronny Schwartz Center, you’ll continue to see your gastroenterologist for appropriate treatment of the problems affecting your esophagus.

Diagnostic tools

The Ronny Schwartz Center for Voice, Swallowing and Motility Disorders offers some of the most advanced tools available for diagnosing complex disorders affecting the throat, vocal cords and esophagus. Our diagnostic services include:

  • High-definition videostroboscopy

The Ronny Schwartz Center is one of only two facilities in San Diego that offers high-definition videostroboscopy. This tool functions like a video camera, providing full color, high clarity images of the vocal cords and other structures inside the throat that can’t be achieved through traditional imaging equipment. For example, the device can captures images of lesions that were previously undetectable, and can simulate real-time vibrations in the vocal cords. This tool is instrumental in helping ear, nose and throat (ENT) surgeons create surgical treatment plans for their patients, and in identifying voice and swallowing problems caused by cancers of the head or neck.

  • High-resolution esophageal manometry

Manometry is a procedure that measures how the muscles in your esophagus contract and relax after you swallow, which is an indication of how well your esophagus is functioning. The high-resolution system offered at the Ronny Schwartz Center is the gold standard for diagnosing motility disorders, allowing your gastroenterologist to pinpoint the underlying cause of your symptoms and effectively treat them. During the procedure, a thin rubber tube called a catheter is passed from your nose down into your esophagus. The catheter contains sensors that measure the rhythm, force and coordination of your esophageal muscles.

  • Fiberoptic endoscopic evaluation of swallowing (FEES)

As the name implies, fiberoptic endoscopic evaluation of swallowing (FEES) is used to test swallowing function. During this procedure, a catheter containing a camera is placed in your throat. The camera records what happens in your throat when you swallow food or beverages.

  • Modified barium swallowing studies
  • Modified barium swallowing studies, also known as MBS, are used to evaluate your swallowing ability via an X-ray. During the procedure, you’ll swallow small amounts of food and beverage mixed with a special solution called barium, which is highly visible during an X-ray. As you swallow, the X-ray will capture images of the food or beverage moving from your mouth into your throat and esophagus.

  • Endoscopy of the upper gastrointestinal tract

  • Esophageal pH testing for motility disorders

pH testing is used to measure whether acid is escaping the stomach and flowing backward into the esophagus, a condition known by several names including acid reflux, gastroesophageal reflux, and GERD.

The Ronny Schwartz Center also offers traditional 24-hour pH testing, in which a catheter containing a sensor that detects acid is passed through your nose and down into your esophagus. The tube remains in place for 24 hours.

In addition, we offer 48-hour wireless pH testing. During this procedure, a small capsule is placed on the wall of your esophagus via a catheter. Once the catheter is removed, the device wirelessly transmits pH measurements to a receiver worn at your waist.