pH Monitoring

pH monitoring measures how often stomach acid enters your esophagus from your stomach. It also measures how long the acid stays in your esophagus.

You might have this test if your doctor thinks you have gastroesophageal reflux (GERD) or if you have heartburn.

Ambulatory pH Monitoring

In ambulatory pH monitoring, your doctor passes a thin tube (catheter) through nose to your esophagus. The tube is left in place for 24 hours. A monitoring device in the tube measures acid levels in your esophagus. A small recorder is attached to the part of the tube that sticks out of your nose. You wear this equipment at home and keep a record of your activities and any symptoms you have. Your doctor removes the tube the next day and reviews the results.

pH Monitoring with EGD and Bravo

A newer way to do pH monitoring uses a capsule that is placed in your esophagus during upper GI endoscopy. This type of pH monitoring is called Bravo.

Your doctor places a capsule (about the size of a large vitamin) that contains a monitoring device in your esophagus through an endoscope (flexible tube equipped with a light and tiny camera). This tube goes down your throat to your esophagus. The capsule is attached to your esophagus with a clip. The capsule collects data for two or three days and then falls off and is passed through your stools. It can be flushed down the toilet. You wear a recorder about the size of a pager on a belt around your waist for two to three days. The information from the capsule is transmitted to the recorder, which you return to your doctor.

EGD with Bravo, or catheter-free wireless capsule Ph monitoring, is more comfortable and allows you to go to work and other activities without a catheter in your nose.

Why it is Done

You might have pH monitoring if your doctor thinks you have gastroesophageal reflux (GERD) or if you have heartburn. You also might have pH monitoring if your doctor wants to check to see if medication to treat your GERD is working to reduce acid levels in your esophagus.

You cannot have Bravo Ph monitoring if you have a pacemaker or implanted defibrillator. You cannot have an MRI (magnetic resonance imaging) study for 30 days after having Bravo Ph monitoring.

What to Expect

Ambulatory pH Monitoring

  • You may be asked to not eat, drink or smoke before your procedure. You also might need to avoid certain medications before EGD. Your doctor goes over these instructions with you.
  • pH monitoring is an outpatient procedure.
  • Your doctor puts pain-relieving medication in your nose to make you more comfortable as the tube is inserted.
  • Your doctor puts a thin, flexible tube (catheter) through your nose and down your esophagus.
  • You might feel like gagging when the tube is put down your throat.
  • Your doctor has you drink water to make sure the tube is in place.
  • The portion of the tube that sticks out of your nose is taped to the side of your face to hold the tube in place.
  • The procedure takes 15 to 30 minutes.
  • A small recorder is attached to the part of the tube that sticks out of your nose. You wear this equipment at home and keep a record of your activities and any symptoms you have.
  • Your doctor explains how to record your activities on the recorder and explains any special instructions.
  • You cannot get the recorder wet; you cannot shower or bathe during the test.

pH Monitoring with EGD and Bravo

  • You may be asked to not eat, drink or smoke before your procedure. You also might need to avoid certain medications before EGD. Your doctor goes over these instructions with you.
  • pH monitoring is an outpatient procedure.
  • You may need to clean out your colon like you would do for a colonoscopy. Your doctor will tell you if this is necessary.
  • You are sedated with medication given through a needle in your arm (intravenously or IV). The medication might make you sleepy. If you feel any discomfort, it should be minimal.
  • Your doctor may numb your throat with a spray before placing the endoscope (tube) in your mouth. You lie on your back or on your side during the procedure. Sometimes, the endoscope needs to be inserted through the rectum.
  • The endoscopy procedure takes less than 30 minutes. You are monitored for an hour or two after the procedure. This waiting period is normal after sedation medication. Then you can go home.
  • You can't drive yourself home after having sedation medication. Be sure to bring someone along or arrange for a ride home.
  • You might need to rest the remainder of the day because you've had a sedative. Usually, you can return to most normal activities. You might notice a sore throat or abdominal bloating for a day or two.
  • Your doctor explains how to record your activities on the recorder and explains any special instructions.
  • You cannot get the recorder wet.

What the Risks Are

Ph monitoring is generally safe. Complications are rare.

Ambulatory pH monitoring

Complications of ambulatory pH monitoring can include aspiration – Breathing in contents from your stomach that have gotten into your esophagus.

pH Monitoring with EGD and Bravo

EGD is safe when performed by doctors who are well trained and experienced. Our doctors have performed thousands of EGD procedures. We take every measure to make sure you are safe and comfortable.

Complications of EGD are not common. Some people have a reaction to sedation medication or bleeding. Infection is a possibility with many procedures. Rarely, you can get a tear in the lining of your stomach or duodenum (part of your small intestine) that needs surgical repair.

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