EndoFLIP (Endoluminal Functional Lumen Imaging Probe)
What is EndoFLIP?
EndoFLIP, which stands for “endoluminal functional lumen imaging probe,” is a special tool that helps doctors understand how well a part of the child’s digestive tract opens, closes and stretches. It is a thin, flexible tube with a small balloon at the tip. During an endoscopy, the doctor places this tube into the esophagus (swallowing tube) or the outlet of the stomach (pylorus) and gently inflates the balloon with liquid to simulate food or liquid being in that part of the digestive tract. Sensors inside the balloon measure how wide and stretchy the digestive tract is.
These measurements show whether a muscle is too tight or has normal strength. EndoFLIP can be used as part of a motility evaluation to better understand swallowing problems, chest or belly pain, trouble eating, vomiting, or problems emptying the stomach.
What Does EndoFLIP Help Diagnose?
EndoFLIP is especially helpful when doctors suspect:
- Esophageal motility disorders, such as achalasia or other problems where the lower esophagus does not relax or open normally
- Eosinophilic esophagitis (EoE), where the esophagus can become stiff or narrow due to inflammation
EndoFLIP is considered an “add-on” test. It does not replace other studies like endoscopy, manometry or imaging. Instead, it adds important details that help your child’s team make clear diagnoses and precise treatment plans.
How is the EndoFLIP Test Done?
At Nationwide Children’s, EndoFLIP is always done while your child is already asleep for an upper endoscopy. Your child receives pediatric anesthesia and continuous monitoring, just as they would for a standard endoscopy. Sometimes there is need for an intravenous (IV) catheter placed before the anesthesia is given.
Once your child is asleep, the doctor:
- Gently guides the endoscope into the esophagus or stomach.
- Passes the EndoFLIP catheter through the mouth and positions the balloon at the area of interest, such as the lower esophagus or pylorus.
- Inflates the balloon a small amount. As the balloon expands, the system measures the diameter (how wide it opens) and pressure at many points inside the balloon, in real time.
The whole EndoFLIP portion usually adds only a short time to the procedure. There are no cuts, and there is no radiation exposure.
What Happens After the Test?
When the measurements are complete, the balloon is deflated and the catheter is removed. Your child wakes up in the recovery area, just as after a regular endoscopy. Mild sore throat, sleepiness or brief nausea from anesthesia may occur, but serious problems from EndoFLIP itself are extremely rare. The risks are similar to those of standard endoscopy and anesthesia.
Your child’s motility team will review the EndoFLIP results along with other test findings and talk with you about what they mean.
Why Nationwide Children’s?
EndoFLIP is a newer technology and is not yet available at many children’s hospitals. It is most useful when interpreted by specialists who focus on motility disorders every day.
At Nationwide Children’s, EndoFLIP is part of a broad set of advanced motility tests available in our Neurogastroenterology and Motility Disorders Center, a global leader in caring for children with complex motility problems. Our team includes pediatric gastroenterologists, surgeons, anesthesiologists, psychologists, dietitians and social workers who work together to understand your child’s symptoms and design a complete care plan. Families travel from around the world to our center because of our expertise, our child-focused environment and our ability to coordinate testing and treatment efficiently and safely.
Medical Reviewer: Peter Lu, MD, Nationwide Children's Hospital
Date Last Reviewed: 2/13/2026
The information provided here is only for general reference and should not take the place of medical care or patient education. If you have any questions, please contact your care team.
