Esophageal pH monitoring

Also known as: pH monitoring - esophageal and Esophageal acidity test

Definition

Esophageal pH monitoring is a test that measures how often and for how long stomach acid enters the tube that leads from the mouth to the stomach (esophagus).

How the test is performed

A thin tube is passed through your nose or mouth to your stomach. Then it is pulled back into your esophagus. The tube is attached to a monitor that measures the level of acidity in your esophagus.

You will wear this monitor on a strap and will be asked to keep a diary of your symptoms and activity over the next 24 hours. The next day you will return to the hospital and the tube will be removed. The information from the monitor will be compared with the diary notes you provide.

Infants and children may need to stay in the hospital for the esophageal pH monitoring.

How to prepare for the test

Your health care provider will ask you to not eat or drink (fast) and avoid smoking after midnight before the test.

Some drugs may change the test results. Your health care provider may ask you to not take those drugs for 24 hours to 2 weeks (or more) before the test, depending on the medication. These substances may include:

• Adrenergic blockers
• Alcohol
• Antacids
• Anticholinergics
• Cholinergics
• Corticosteroids
• H2 blockers
• Proton pump inhibitors

Do not stop taking any medication unless told to do so by your health care provider.

How the test will feel

You may experience a brief gagging sensation as the tube is passed through your throat.

Why the test is performed

Esophageal pH monitoring is used to check how much stomach acid is entering the esophagus, and how well it is cleared downward into the stomach. It is a test for gastroesophageal reflux disease (GERD).

This test can also be performed during upper GI endoscopy by clipping a pH monitoring device to the lining of the esophagus. In infants, this test is also used to check for GERD and related excessive crying or other problems.

Normal Values

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Increased acid in the esophagus may be a sign of, or occur with:

• Barrett's esophagus
• Difficulty swallowing (dysphagia)
• Esophageal scarring
• Gastroesophageal reflux disease (GERD)
• Heartburn
• Reflux esophagitis

If you are suspected to have esophagitis, you may need these additional tests:

• Barium swallow
• Esophagogastroduodenoscopy (also called upper GI endoscopy)

What the risks are

No significant risks have been reported with this test, but the following may occur rarely:

• Arrhythmias during insertion of the tube
• Breathing in of vomit if the catheter causes vomiting (See: Aspiration of vomitus)

References

Richter JE, Friedenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 43.

Orlando RC. Diseases of the esophagus. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 140.

See also:

• Disease

  Gastroesophageal reflux disease

  

  Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

• Test

  EGD - esophagogastroduodenoscopy

  

  Esophagogastroduodenoscopy (EGD) is an examination of the lining of the esophagus, stomach, and upper duodenum with a small camera (flexible endoscope) which is inserted down the throat.

• Test

  Upper GI and small bowel series

  

  An upper GI and small bowel series is a set of taken to examine the esophagus, stomach, and small intestine. See also:

• Disease

  Esophagitis

  

  Esophagitis is a general term for any inflammation, irritation, or swelling of the esophagus, the tube that leads from the back of the mouth to the stomach. See also:

• Symptoms

  Crying - excessive (0-6 months)

  

• Symptoms

  Swallowing difficulty

  

  Difficulty with swallowing is the sensation that food is stuck in the throat, or from the neck down to just above the abdomen behind the breastbone (sternum).

• Symptoms

  Heartburn

  

  Heartburn is a painful burning sensation in the esophagus, just below or behind the breastbone. The pain often rises in your chest and may radiate to your neck or throat.

Review date:

November 11, 2010

Reviewed by:

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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