A step-by-step transformation

Progressing the pathway to esophageal health

Discover our esophageal care portfolio

When you are seeking an advanced diagnosis and treatment pathway, our portfolio offers a wide range of solutions to address esophageal diseases and conditions, including GERD, Barrett’s Esophagus, GI bleeding and motility disorders. 

50% of endoscopies for predominant esophageal symptoms are inconclusive1, leaving patients facing uncertainty in esophageal diagnoses, and medical professionals coping with prolonged pathways to prognosis and treatment.

Delivering meaningful innovation and comprehensive solutions from diagnosis to treatment.

We provide a full-spectrum portfolio offering a step-by-step pathway from detection to treatment of esophageal diseases using advancements in medical technology. 

Why choose our portfolio

Delivering meaningful innovation and comprehensive solutions for esophageal care from diagnosis to treatment.
Explore our portfolio

Our commitment to your success

We go above and beyond to support you.

We transform the pathway with extensive training and technical support, guiding you every step of the way enabling you with the solutions you need.

Our clinical education and training programmes are designed to help you provide comprehensive solutions and improve patient care. We are committed to delivering targeted educational resources aimed at helping you achieve procedural and clinical proficiency.

Progressing the pathway to esophageal health.

Our step-by-step transformation

Tailoring solutions for better esophageal health

Understanding the root cause

The first step towards healing begins with understanding the underlying factors contributing to esophageal diseases. Two simple tests can transform how you evaluate esophageal motility disorders and GERD.

Endoflip™ impedance planimetry system measures dimensions and pressure in real-time to evaluate suspected esophageal motility disorders. Impedance planimetry of the upper gastrointestinal tract significantly improves diagnostic evaluations and informs therapeutic decision-making.3

Bravo™ calibration-free reflux testing system measures acid levels in the esophagus for up to 96 hours.7 Early ambulatory esophageal pH monitoring (in conjunction with endoscopy and manometry) before long-term PPI initiation may help define which patients can avoid PPI use and potentially prevent excess PPI dependence.6

Ensuring a confident outcome for your patients

Nexpowder™* Endoscopic Hemostasis System is an endoscopic hemostasis system for active bleeds that shows promising results also in the prevention of delayed re-bleeding after resection. By delivering a powdered hemostatic agent directly to the bleeding site, Nexpowder™* transforms into a highly adhesive gel that creates a mechanical barrier.8-11 

Learn more about Nexpowder™*

Personalizing treatment plans according to patient needs

Reduce the risk of progression of Barrett's Esophagus (BE) with proven effective and durable therapy.19 Barrx™ radiofrequency ablation system enables the removal of Barrett’s mucosa, while preserving the underlying submucosal tissue.4 Clinical studies have demonstrated the safety and efficacy of RFA for treating all grades of Barrett's Esophagus.2,3 

Barrx™ radiofrequency ablation should be considered for patients with confirmed low-grade dysplasia and high-grade dysplasia without visible abnormalities.21

Barrx™ radiofrequency ablation results in complete eradication of dysplasia in 80-90% of patients with Barrett´s Esophagus.22

The Barrx™ radiofrequency ablation system includes the Barrx™ Flex radiofrequency ablation energy generator and a family of ablation catheters (focal and circumferential), which are designed to precisely control depth and uniformity of gastrointestinal tissue ablation. 22

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Risk information

Please refer to product user manual or medtronic.com/covidien/uk for detailed information.

Barrx™ radiofrequency ablation system

Indications: The Barrx™ 360 Express RFA Balloon Catheter is indicated for use in the coagulation of bleeding and non-bleeding sites in the gastrointestinal tract, including but not limited to, Barrett’s esophagus and esophageal squamous cell neoplasia, defined as moderate grade intraepithelial neoplasia (MGIN), high grade intra-epithelial neoplasia (HGIN), and/or early squamous cell carcinoma (SCC) of the esophagus limited to the lamina propria (i.e., T1m2). The Barrx™ 90, Barrx™ Ultra Long and Barrx™ 60 RFA Focal Catheters are indicated for use in the coagulation of bleeding and non-bleeding sites in the gastrointestinal tract including but not limited to, Barrett’s esophagus and esophageal squamous cell neoplasia, defined as moderate grade intraepithelial neoplasia (MGIN), high grade intra-epithelial neoplasia (HGIN), and/or early squamous cell carcinoma (SCC) of the esophagus limited to the lamina propria (i.e., T1m2).

Contraindications: Contraindications include pregnancy, prior radiation therapy to the esophagus, esophageal varices at risk of bleeding, prior Heller myotomy and cosinophilic esophagitis.

Risks: The following are transient side effects that may be expected after treatment: chest pain, difficulty swallowing, painful swallowing, throat pain and/or fever.

Potential complications include mucosal laceration, minor or major bleeding, endoscopic clipping to manage mucosal laceration or bleeding, perforation of the stomach, esophagus or pharynx, surgery to manage perforation, esophageal stricture, endoscopic dilation to manage stricture, pleural effusion, transfusion secondary to major bleeding, cardiac arrhythmia, aspiration, infection, death.

Bravo™ Reflux Testing System

Indications: The Bravo™ monitoring system is intended to be used for gastroesophageal pH measurement and monitoring of gastric reflux in adults and children from 4 years of age. The Bravo™ capsule can be attached following either endoscopy or manometry. The Reflux/Accuview™ software application is intended to record, store, view and analyze gastroesophageal pH data.

Contraindications: Patients with bleeding diathesis, strictures, severe esophagitis, varices or obstructions. Patients with pacemakers or implantable cardiac defibrillators.

Risk: Aspiration, tears or perforations in the mucosa, discomfort associated with the capsule, premature detachment or failure to detach, which may necessitate endoscopic removal. The safety and efficacy has not been established for pediatric use on patients below the age of 4. Patients are restricted from undergoing an MRI study within 30 days of the start of a reflux study. Use of the Bravo™ reflux testing system in an MRI magnetic field will result in damage to the system and possible patient injury. Undergoing an MRI while the Bravo™ reflux capsule is inside the patient’s body may result in serious damage to the patient’s intestinal tract or abdominal cavity. If the patient did not positively verify the excretion of any Bravo™ reflux capsule, the patient should contact the physician for evaluation and possible abdominal x-ray before undergoing an MRI examination. The Bravo™ reflux capsule contains a trocar needle that is made of stainless steel. Use caution in patients with known sensitivities to the metals that are contained including chromium, nickel, copper, cobalt and iron. Tests last from 48 to 96 hours.

Gastrointestinal endoscopy: Potential complications include, but are not limited to: perforation, hemorrhage, aspiration, fever or infection, hypertension, respiratory arrest and cardiac arrhythmia or arrest.

Nasal intubation: Potential complications include, but are not limited to: Sore throat, discomfort and nasopharyngeal damage resulting in bleeding and soft tissue damage.

Endoflip™ impedance planimetry system

Indications: The Endoflip™ System is used in a clinical setting to obtain an estimation of the dimensions and balloon pressure within the alimentary canal. The FLIP™ Topography System is an accessory to the Endoflip™ System. The FLIP™ Topography System is indicated for use with an Endoflip™ System in a clinical setting to measure pressure and dimensions in the esophagus, pylorus and anal sphincters. It is intended to be used as an adjunct to other diagnostic methods as part of a comprehensive evaluation of patients with symptoms consistent with gastrointestinal motility disorders.

Contraindications: Where endoscopy is contraindicated In patients with actively bleeding varices in the esophagus

Potential complication include: Allergic reaction Anaphylaxis Bleeding Cardio-respiratory complications, Dental trauma, Infection, Pain, Perforation, Pulmonary aspiration, Vasovagal response.

Precautions: Do not reuse, reprocess or sterilize the catheters. Reuse, reprocessing or sterilization can compromise the structural integrity of the device, impair performance accuracy due to residual fluid in the balloon and degrade the catheter markings. All catheter components are intended for single patient use only. Do not attempt to reuse. Follow all applicable Federal and local regulations for disposal or recycling. To ensure proper operation and to minimize the risk of patient injury, do not attempt to add or remove fluid from the supplied pre-filled syringes. Only use the pre-filled syringe supplied with the catheter. Do not use this device for any purpose other than the indicated use. Inspect the device packaging before use and do not use the device if any damage to inner pouch or device is observed. Do not use the catheter if excessive resistance is met during insertion or removal. Prior to repositioning or removal, ensure complete deflation of the balloon.

Nexpowder™* endoscopic hemostatic system

Indications: Nexpowder™* is used for most GI bleeding. The device is applied during an endoscopic procedure and can cover ulcer or bleeding sites. The device is not intended for use in patients with variceal bleeding. Note: Do not use this device for any purpose other than stated intended use. 

Contraindications: Because the Nexpowder™* system includes lactose, it is contraindicated in patients who have galactose intolerance, lapp lactase deficiency or glucose-galactose malabsorption and they would be at risk of having nausea, bloating and diarrhea. Because the Nexpowder™* system includes Brilliant Blue FCF, it must not be used in patients with known hypersensitivity to brilliant blue FCF.

Warning: Nexpowder™ has not been approved for use in pregnant women, nursing mothers and pediatric population and there is no safety or efficacy data in these groups. Patients that are on antithrombotic medication may be at an increased risk of re-bleeding. Take individual patient needs and relevant clinical guidelines into account when managing antithrombotic agents for endoscopic procedures. Consider consulting the physician responsible for the antithrombotic if needed. This medical device is designed for single use only. Attempts to resterilize and/or reuse may lead to device failure and/or transmission of disease.

Precautions: This medical device must be delivered under a physician’s direction. Nexpowder™ is a sterilized medical device and should not be re sterilized and reused. If the package is damaged or opened, or if device is damaged, do not use. If an abnormality is detected that would prohibit proper working conditions, do not use. Please notify a NEXTBIOMEDICAL CO., LTD. representative. If Nexpowder™ is exposed to skin and eyes, refer to the following First aid measure: Skin: Wash with soap and water until clean. Eyes: Flush with water until irritation ceases.

Potential complications: Those associated with gastrointestinal endoscopy include, but are not limited to: hemorrhage, perforation, aspiration, fever, infection, allergic reaction, and foreign body sensation in the digestive tract.


1. ASGE Standards of Practice Committee, Muthusamy VR, Lightdale JR, Acosta RD et al. The role of endoscopy in the management of GERD. Gastrointest Endosc. 2015;81(6):1305 10.

2. FDA 510k Clearance K170833, April 17, 2017.

3. Ahuja NK, Agnihotri A, Lynch KL, et al. Esophageal distensibility measurement: impact on clinical management and procedure length. Diseases Of The Esophagus: Official Journal Of The International Society For Diseases Of The Esophagus. 2017;30(8):1-8.

4. Fleischer DE, Overholt BF, Sharma VK, et al. Endoscopic ablation of Barrett’s esophagus: a multicenter study with 2.5‑year follow‑up. Gastrointest Endosc. 2008;68:867‑876.

5. Hirano I, Zhang Q, Pandolfino JE, Kahrilas PJ. Four day Bravo™ reflux testing system pH capsule monitoring with and without proton pump inhibitor therapy. Clin Gastroenterol & Hepatol. 2005;3(11):1083–1088.

6. Triadafilopoulos, G., Zikos, T., Regalia, K. et al. Use of Esophageal pH Monitoring to Minimize Proton-Pump Inhibitor Utilization in Patients with Gastroesophageal Reflux Symptoms. Dig Dis Sci 63, 2673–2680 (2018). https://doi.org/10.1007/s10620-018-5183-4

7. Hasak S, Yadlapati R, Altayar O, Sweis R, Tucker E, Knowles K, Fox M, Pandolfino J, Gyawali CP, Prolonged Wireless pH Monitoring in Patients With Persistent Reflux Symptoms Despite Proton Pump Inhibitor Therapy, Clinical Gastroenterology and Hepatology (2020), doi: https://doi.org/10.1016/j.cgh.2020.01.031. 

8. Gralnek I, Dumonceau JM, Kuipers E, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2018;47:1-46

9. Park JS, Bang BW, Hong SJ, et al. Efficacy of a novel hemostatic adhesive powder in patients with refractory upper gastrointestinal bleeding: a pilot study. Endoscopy. 2019 May;51(5):458-462

10. Park JS, Kim HK, Shin YW, et al. Novel hemostatic adhesive powder for nonvariceal upper gastrointestinal bleeding. Endosc Int Open. 2019 Dec;7(12):E1763-E1767

11. Bang B, Lee E, Maeng J, et al. Efficacy of a novel endoscopically deliverable mucoadhesive hemostatic powder in an acute gastric bleeding porcine model. PLoS One. 2019 Jun 11;14(6):e0216829

12. Phoa et al, Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial JAMA 2014;311:1209-17.

13. Weusten Bas et al. Endoscopic management of Barrett’s Esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Postion Statement. Endoscopy 2017;49: 191-198 .

14. Chadwick G. et al. Systematic review comparing radiofrequency ablation and complete endoscopic resection in treating dysplastic Barrett’s esophagus: a critical assessment of histologic outcomes and adverse events. Gastrointest Endosc 2014; 79: 718- 731 e3.

15. Orman et al. Efficacy and Durability of RFA for BE: systematic review and meta-analysis. Clinical Gastroenterology and Hepatology 2013;11:1245- 1255.

16. Hathorn et al. Predictors of complications from radiofrequency ablation during treatment of Barrett’s esophagus: results from the U.S. RFA registry. Gastrointestinal Endoscopy 2014;79(5), AB152-153. 2014 DDW Abstracts.

17. Bulsiewicz et al. Safety and efficacy of endoscopic mucosal therapy with RFA in patients with neoplastic BE. Clinical Gastroenterology and Hepatology 2013;11(6):636-42.

18. Gupta et al. Recurrence of esophageal intestinal metaplasia after EMR and RFA of BE: results from a US multicenter consortium recurrence of BE after EMR and RFA. Gastroenterology 2013;145(1):79-86

19. Halland.M. Recent developments in pathogenesis, diagnosis and therapy of Barrett's Esophagus. World Journal of Gastroenterology 2015 June 7; 21(21): 6479-6490.

20. Lyday et al. RFA of BE: outcomes of 429 pats from a multicenter community practice registry. Endoscopy 2010;42(4):272-8.

21. Whiteman DC, et al. Australian clinical practice guidelines for the diagnosis and management of Barrett's esophagus and early esophageal adenocarcinoma. J Gastroenterol Hepatol 2015; 30: 804-20.

22. Phoa KN. et al. Multimodality endoscopic radication for neoplastic Barrett oesophagus: results of an European multicentre study (EURO-II). Gut 2015; doi 10.1136/gutjnl-2015-309298

23. Shaheen et al. Prior fundoplication does not improve safety or efficacy outcomes of RFA: results from the US RFA Registry. J Gastrointest Surg 2013;17(1):21-8.

24. Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2015.