pH monitoring

overview

The procedure known as pH monitoring measures how often stomach acid enters the esophagus from the stomach. It also measures how long the acid stays in the esophagus. You might have this test if your doctor thinks you have gastroesophageal reflux (GERD) or if you have heartburn. You also might have pH monitoring to see if medication to treat your GERD is working to reduce acid levels in your esophagus.

types

There are two types of pH monitoring:

  • Ambulatory pH monitoring, when your doctor passes a thin tube (catheter) through your 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.
  • EGD with Bravo. A capsule about the size of a large vitamin that contains a monitoring device is placed in your esophagus during upper GI endoscopy. You wear a recorder about the size of a pager on a belt around your waist. The information from the capsule is transmitted to the recorder, which you return to your doctor. The capsule collects data for 2 or 3 days and then falls off and is passed through your stool. It can be flushed down the toilet. EGD with Bravo, also called catheter-free wireless capsule pH monitoring, allows you to go to work and enjoy other activities without a catheter in your nose. 

what to expect

If you need Ambulatory pH monitoring, you may be asked not to eat, drink or smoke before your procedure. You also might need to avoid certain medications. Your doctor puts pain-relieving medication in your nose to make you more comfortable, then places a thin, flexible tube (catheter) through your nose and down your esophagus. You’ll be asked to drink a little water to be sure the tube is in place. The bit of the tube that sticks out of your nose will be taped to the side of your face. A small recorder is attached to the part of the tube that sticks out of your nose. The whole procedure takes 15 to 30 minutes.

You’ll wear this equipment at home and keep a record of your activities and any symptoms you have. Your doctor will explain how to record your activities on the recorder. 

If you have Bravo pH monitoring, you may be asked not to eat, drink or smoke before your procedure. You also might need to avoid certain medications. If your doctor thinks it’s necessary, you may need to clean out your colon as you would for a colonoscopy.
 
You’ll be sedated and any discomfort should be minor. Your doctor may numb your throat with a spray before placing the endoscope in your mouth. Sometimes, the endoscope needs to be inserted through the rectum. The endoscopy procedure takes less than 30 minutes, then you’ll be monitored for an hour or two, after which you can have someone pick you up and drive you home. You might need to rest the remainder of the day, but you can usually resume normal activities the next day. You might notice a sore throat or abdominal bloating for a day or two.

Your doctor will explain how to record your activities on the recorder and explain any special instructions.

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