Esophageal mobility: what is the FLIP exam?

By Cristiano Antonino On Apr 12, 2023

The FLIP, or EndoFLIP, is a diagnostic tool that offers accurate measurements in certain areas of the gastrointestinal system

What is FLIP (or EndoFLIP)?

It is a diagnostic tool that uses a minimally invasive probe.

This probe is essential for imaging the functional endoluminal lumen.

EndoFLIPs use a small sensory balloon that gives the doctor measurements of the esophagus and thus information for diagnosis.

Doctors often perform EndoFLIP procedures in conjunction with upper endoscopies.

An endoscopy is a procedure that examines the digestive tract.

During an endoscopy, the patient is sedated or has some type of numbing medication.

The doctor then runs a thin tube with a camera on the end down the esophagus, stomach, and small intestine to get a look at these areas.

Sometimes sedation of the patient is necessary.

The sensory balloon is filled with an ionic fluid, and is fitted with electrodes that take measurements.

EndoFLIPs are given to people with gastrointestinal problems

They can help diagnose problems such as:

Achalasia
Dysphagia
Eosinophilic esophagitis
Esophageal atresia
Tracheoesophageal fistula
Pathologies diagnosable with FLIP

Achalasia

Achalasia is a disorder that makes it difficult for food to pass from the esophagus to the stomach.

This is due to damaged nerves within the esophagus, eventually resulting in paralysis of the esophagus.

It’s not clear why these nerves become damaged, but researchers suspect this could happen due to a viral infection or an autoimmune response.

Symptoms of achalasia include:

The inability to swallow
Vomiting or regurgitation
Stomach ache
Chest pain
Belching
Pneumonia, caused by inhaling food into the lungs
Weight loss

There is no cure for achalasia, but symptom management is possible.

Dysphagia

People with dysphagia have trouble swallowing.

Doctors often use an EndoFLIP to figure out what might be causing dysphagia since there are many potential causes.

Symptoms can include:

Inability to swallow or pain when swallowing
Coughing, retching or regurgitation
Frequent heartburn or stomach acid in the throat
Sensation of food stuck in the throat
Hoarseness
Hypersalivation
Weight loss
Eosinophilic esophagitis

Eosinophilic esophagitis is swelling or inflammation of the esophagus due to an allergic reaction.

It is often caused by an allergic reaction to food.

Symptoms of eosinophilic esophagitis include:

Difficulty swallowing or food stuck in the throat
Vomit
Chest pain
Refusal to eat, especially in young children

Esophageal atresia

Esophageal atresia is a birth defect that causes the baby’s esophagus to develop incorrectly.

There are four types of esophageal atresia:

Type A. This is when the upper and lower parts of the esophagus partially develop but do not connect. Instead, each unattached end is closed.

Type B. This is when the upper part of the esophagus is attached to the trachea, but does not connect to the lower part, which has a closed end. Type B is very rare.

Type C. This is when the lower part of the esophagus attaches to the trachea and the upper part is closed. Type C is the most common type.

Type D. This is when both the upper and lower parts of the esophagus are connected to the windpipe rather than to each other. Type D is very severe and also the rarest type of esophageal atresia.

Researchers don’t know what causes esophageal atresia. It often occurs with other birth defects, most commonly a tracheoesophageal fistula.