Gastrointestinal Diagnostics & Procedures

Medical Procedures Unit Provides Multidisciplinary Diagnostic Services

The Gastroenterology Division at the University of Michigan provides specialized diagnostic and therapeutic procedures and services to diagnose and treat patients with a wide variety of gastrointestinal disorders. Approximately 15,000 procedures are performed annually at our multidisciplinary Medical Procedures Unit, located in Ann Arbor at University Hospital. The Medical Procedures Unit is one of the largest and most advanced facilities in the country, equipped with cutting-edge gastroenterology equipment to support patient care and clinical research. In addition to the Medical Procedures Unit our faculty also perform select procedures at various U-M health centers throughout Southeast Michigan.  Specialized gastrointestinal services include:

• Colonoscopy and Colon Cancer Screening: An exam using a tube-like instrument to look inside the rectum and colon for polyps, abnormal areas or cancer. Tissue samples can be collected (biopsy) and abnormal growths can be removed.
• Balloon-Assisted Endoscopy: A balloon inflating the sides of the bowel allows an endoscope to reach farther into the bowel for a visual examination.
• Botulinum Toxin (Botox®) Injection for Achalasia
• Capsule Endoscopy: A capsule containing a camera is swallowed by the patient to take pictures along the digestive tract not easily reachable by other procedures. (The capsule passes normally in the stool.)
• Cryotherapy: Cryotherapy uses extreme cold to freeze and destroy tissue. It has been used for decades to treat common skin lesions, such as warts.
• EndoFLIP:  EndoFLIP is a technology that simultaneously measures the area across the inside of a gastrointestinal organ (for example, the esophagus) and the pressure inside that organ.
• Endoscopic Retrograde Cholangiopancreatography (ERCP): Uses an endoscope to visually examine the pancreas and bile ducts.
• Endoscopic Ultrasound: Uses an endoscope to examine the upper and lower gastrointestinal tract, and then creates detailed pictures using ultrasound imaging.
• Endoscopic Mucosal Resection (EMR): For people with Barrett’s Disease, this procedure uses an endoscope and the injection of a solution into the esophagus or stomach to raise and remove a lesion for examination.
• Bravo® (catheter-free or wireless) esophageal pH monitoring study: A small capsule is attached to the lining of the esophagus during an upper endoscopy to measure acidic reflux over a 48-hour period. The capsule sends these measurements wirelessly to a small receiver that the patient wears.  (The capsule passes normally in the stool.)
• Esophageal 24-hour pH/impedance reflux monitoring: A catheter is placed through the nasal passage into the esophagus to record amount of reflux over a 24-hour period.
• High Resolution Esophageal Manometry (Esophageal Mano): A catheter is placed through the nasal passage to record the movement and pressures of the esophagus as the patient drinks small amounts of water.
• Liver Biopsy: Uses a needle to remove a sample of liver tissue for examination.
• Liver Elastography: A non-invasive exam using an ultrasound probe to apply pulse waves to the liver to determine how much scar tissue has accumulated from chronic liver diseases.
• Peroral Endoscopic Myotomy (POEM): Peroral endoscopic myotomy (POEM) is an endoscopic therapy for achalasia.
• Pneumatic Dilation: An air-filled cylinder-shaped balloon disrupts the muscle fibers of the lower esophageal sphincter, which is too tight in patients with achalasia.
• Pouchoscopy: Uses an endoscope to examine a surgically created pouch that serves as a stool reservoir for people whose large bowel has been completely removed.
• Radiofrequency Ablation (RFA): Radiofrequency ablation (RFA) is an endoscopic therapy used primarily to treat Barrett’s esophagus.
• Sigmoidoscopy: Uses an endoscope to examine the lower 20 inches of the colon.
• Upper Endoscopy (EGD): Uses a thin, flexible tube with a camera inserted through the mouth, following the tract to the stomach and upper small intestine, to look for bleeding, ulcers and inflammation.

Comprehensive Gastrointestinal Examinations and Procedures

• Paracentesis: A procedure using a needle to drain fluid from the abdomen.
• Barrett's Epithelium Ablation Therapy (HALO®): Uses the advanced HALO system to endoscopically remove diseased tissue from the esophagus of patients with Barrett’s Disease.
• Confocal Microscopy (Cellvizio®):  An advanced form of imaging using a tiny microscope to perform “virtual biopsies” and other exams, especially useful for patients with Barrett’s Disease and those with narrowing of the bile and pancreatic ducts.
• Endoscopic Dilation: A technique to open a blocked section of the esophagus.
• PEG Tube Placement: Using an endoscope to place into the stomach through the skin.

GI Services at the Gastrointestinal Physiology and Manometry Laboratory 

• Hydrogen Breath Test: Tests for bacterial overgrowth and intolerance to sugars (fructose, lactose, sucrose).
• Esophageal Manometry: Measures both the movement and pressures in the espophogus.
• Anorectal Manometry: Detects problems with bowel movement by measuring the tone in the anal sphincter and rectal muscles.
• Esophageal 24-hour pH Monitoring: During a 24-hour period, both acid and non-acid reflux is monitored in the esophagus.
• Secretin Stimulation Test: Measures the ability of the pancreas to respond to secretin, a digestive hormone.
• Gastrointestinal Motility Studies: Exam to look at how the stomach and upper small intestinal muscles contract.

Medical Procedures Unit Hours of Service

The Medical Procedures Unit schedules services Monday through Friday. Procedures are scheduled from 7:00 am to 4:00 pm, and the recovery room is open until 7:00 pm. An on-call staff services the adult and pediatric gastrointestinal endoscopy service overnight and on weekends.  Click on the procedure you need to learn more about the community health center location options.