Priyanka K. Gill, MD1, Mashal Fida, MD1, Christopher N. Andrews, MD, MSc2, Michelle Buresi, MD1, Dorothy Li, MD1, Yasmin Nasser, MD1, Matthew Woo, MD1, Milli Gupta, MD, BSc1 1University of Calgary, Calgary, AB, Canada; 2University of Calgary Cumming School of Medicine, Calgary, AB, Canada Introduction: The Endoluminal Functional Lumen Imaging Probe (FLIP) is a transoral catheter-based tool used to aid in the diagnosis of esophageal motility disorders. The standard of care is performing FLIP at time of sedated endoscopy. This can pose challenges in a resource constrained setting. Esophageal manometry (HRM), involving the transnasal placement of a catheter in an unsedated patient, has a success rate of > 99%. In our center, we perform FLIP in unsedated patients in the motility lab. Our study aimed to compare the tolerability and overall success of esophageal manometry and unsedated esophageal FLIP. Methods: We conducted a prospective cross-sectional study of patients that underwent HRM or unsedated esophageal FLIP between August 2023 and April 2025. Patients were provided a questionnaire following the procedure to track adverse events during catheter insertion and recording. Data on tolerability was collected, as were other demographic- and outcome-related parameters. The incidence of patient-reported adverse effects was compared with Chi-squared tests and the intensity of pain on a 10-point VAS and overall experience were compared with Mann-Whitney U. Results: A total of 88 patients (62 [70.5%] female, median age 58.5 years) underwent HRM (61 [69.3%]) or FLIP (27 [30.7%]) and were included in this analysis. There was no significant difference between reported adverse events occurring during FLIP versus HRM except for ‘other’, reported in 37% FLIP and 11% HRM (p=.007) during insertion. Gagging was reported by 30% and pain/pressure by 7% FLIP patients and gagging by 11% HRM patients. During recording, vomiting was reported by 16% HRM patients vs. 0% FLIP (p = .029). In terms of overall experience, global distress was statistically different with a median score of 3 for FLIP and 2 for HRM (p=.017). There was no difference in global symptoms between age < 65 and age > 65, or sex. There was no difference in overall success between FLIP and HRM with technical success seen in 93% FLIP and 95% HRM (p=0.49). Discussion: There are no significant differences between adverse events associated with FLIP versus HRM, except for gagging at time of insertion, which was higher in FLIP patients. However, there was no difference in overall success between both procedures suggesting that unsedated FLIP is well tolerated and safe to perform in the motility lab.
Disclosures: Priyanka Gill indicated no relevant financial relationships. Mashal Fida indicated no relevant financial relationships. Christopher Andrews: Abbvie – Advisor or Review Panel Member. Alimetry – Independent Contractor, Stock Options, Stock-privately held company. Avir – Advisor or Review Panel Member. Bausch Health – Advisor or Review Panel Member, Speakers Bureau. Knight Pharma – Advisor or Review Panel Member, Speakers Bureau. Nestle – Grant/Research Support. Nimble Science – Consultant, Stock Options, Stock-privately held company. Pendopharm – Advisor or Review Panel Member. Sanofi/Regeneron – Advisor or Review Panel Member. Takeda – Advisory Committee/Board Member. Michelle Buresi: Lupin Pharma, Sanofi/Regeneron, AVIR Pharmaceuticals, Bausch Health, Eli Lilly, Pfizer, Sandoz Canada – Advisory Committee/Board Member, Speakers Bureau. Dorothy Li indicated no relevant financial relationships. Yasmin Nasser indicated no relevant financial relationships. Matthew Woo: Medtronic – Consultant, Speakers Bureau. Sanofi/Regeneron – Consultant, Speakers Bureau. Milli Gupta: AstraZeneca – Consultant. AVIR Pharma Inc – Consultant. Bristol Myers Squibb – Grant/Research Support. Celldex – Grant/Research Support. Dr. Falk – Grant/Research Support. Eupraxia – Consultant, Grant/Research Support. Pentax – Consultant. Regeneron Pharmaceutical Inc. – Consultant. Sanofi – Consultant.
Priyanka K. Gill, MD1, Mashal Fida, MD1, Christopher N. Andrews, MD, MSc2, Michelle Buresi, MD1, Dorothy Li, MD1, Yasmin Nasser, MD1, Matthew Woo, MD1, Milli Gupta, MD, BSc1. P0623 - Patient Tolerance of Unsedated Endoluminal Functional Lumen Imaging Probe and High-Resolution Manometry in a Tertiary Care Center in Canada, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
