The 24hr oesophageal pH study measures how often and how much acid from the stomach enters the oesophagus over a 24 hour period which may be accountable for your symptoms of reflux, cough or chest pain. Normally the stomach contents do not enter the oesophagus due to constricted Lower oesophageal sphincter (LES). LES acts like a valve between the oesophagus and stomach preventing food from moving backward into the oesophagus. But in patients with GORD (Gastro-oesophageal reflux disease) stomach contents travel back into the oesophagus because of a weak or relaxed LES.
It is often done in conjunction with the oesophageal manometry which measures pressures in the oesophagus.
It is primarily performed for the following reasons:
- Diagnose and quantify gastro-oesophageal reflux disease (GORD).
- To determine if chronic cough, sore throat or recurrent chest pain (With negative work up of cardiology) is seconary to reflux.
- As part of work up prior to weight loss (bariatric) surgery or Hiatus hernia repair/Nissen fundoplication.
- To differentiate functional oesophageal disorders/non acid re flux from acid reflux.
- To determine the effectiveness of medications that are given to prevent acid reflux.
You will be advised to stop your acid suppression medication in order to prepare for this study.
Please see this information sheet for instructions to find out more details about preparing:
- 7 days before your appointment
- 3 days before your appointment
- 1 day before your appointment
- Day of your appointment
- During Study
Procedure involves the placement of a catheter (about the size and flexibility of a smartphone power cord) through your nasal passage, down the back of your throat and in the oesophagus with drinks of water. The other end of the catheter will be taped to your cheek, wrapped over your ear, and attached to a small data recorder (see Image) that you will wear at waist level, held by a strap over your shoulder. A local anaesthetic was administered to your nasal passage to decrease discomfort during catheter placement. Therefore, do not eat or drink for at least one hour after the procedure.
It is normal to feel the probe in the back of your throat and this feeling should improve over a few hours.
You will be able to swallow, talk, and breathe without any difficulty during the test. This tube has sensors at standard distances which measure the PH change in real time and record the amount of PH change that occurs in your normal 24 hours period.
You will be advised to press the appropriate buttons on the recorder as below:
Please complete the patient diary as concisely as possible; use the time displayed on the recorder to write down the time of events in the diary.
The next day, you will be required to return to have the catheter removed and to turn in the diary.
Removing the catheter takes less than one minute. You will be instructed, where to return the equipment.
- Please treat the equipment with respect, do not leave it in sunlight or near water.
- The catheter is single use only but leave the catheter attached with the recorder.
The information from the data-recorder is downloaded on a computer for assessment. An appointment will be made with your Gastroenterologist to discuss the results.
PH Study is a very safe procedure.
- The risk of causing serious harm to you with this test is very rare. Complications are very infrequent.
- Minor side effects of PH study could include a runny nose or discomfort in the nose and throat. This is caused by the tube that irritates or inflames the nasal tissue or throat. Both of which usually disappear on the removal of the tube.
- Rarely, there could be a nose bleed as a result of the procedure.
- Occasionally, during insertion, the tube may enter the larynx (voice box) and cause temporary choking feeling.
- When this happens, it is usually recognised immediately, and the tube is rapidly removed.
Placement of the catheter generally takes about 10 minutes, but if you are also having an oesophageal manometry
your appointment will take longer. Give yourself at least an hour for this appointment.
- Wear loose comfortable clothing that buttons up in front as you will be required to pass the tube underneath your clothing.
- Please refrain from wearing make-up and do not apply moisturizer to your face or neck.
- You cannot take a shower or bath while wearing the monitor.
- You should otherwise go about your daily routine and eat your regular diet in order to get a realistic recording of how much reflux occurs during your usual routine.
- You should be careful around pets and small children to make sure they do not come close enough to accidentally pull the catheter out.
- No x-rays while the catheter is in place.
- Do not operate a microwave while catheter is in place.
- Since there is no anaesthesia/sedation involved, you can drive yourself home.
- You cannot be put to sleep or sedated during the procedure. You will be asked to sit upright on a couch.
- You do not necessarily need to be accompanied by a family member or friend for this appointment. They are welcome to attend however they generally will not be able to come into the room during the procedure but there is plenty of seating in the waiting area should you wish to bring someone for your support.
If you have any questions or need advice please contact our rooms.