Esophageal pH monitoring

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

Definition

Esophageal pH monitoring is a test that measures how often stomach acid enters the tube that leads from the mouth to the stomach (called the esophagus). The test also measures how long the acid stays there. 

How the test is performed

A thin tube is passed through your nose or mouth to your stomach. The tube is then is pulled back into your esophagus. A monitor attached to the tube measures the acid level in your esophagus.

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

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 after midnight before the test. You should also avoid smoking.

Some medicines may change the test results. Your health care provider may ask you to not take these for between 24 hours and 2 weeks (or more) before the test. You also may be told to avoid alcohol. Medicines that you may need to stop include:

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

Do not stop taking any medicine 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. It also checks how well the acid 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 monitor to the lining of the esophagus. In infants, this test is also used to check for GERD and other problems related to excessive crying.

Normal Values

Normal value ranges may vary depending on the lab doing the test. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Increased acid in the esophagus may be related to:

  • Difficulty swallowing (dysphagia)
  • Esophageal scarring
  • Gastroesophageal reflux disease (GERD)
  • Heartburn
  • Reflux esophagitis

You may need to have the following tests if your doctor suspects esophagitis:

What the risks are

Rarely, but the following may occur:

  • Arrhythmias during insertion of the tube
  • Breathing in of vomit if the catheter causes vomiting

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.

Katzka DA, Falk G. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 140.



 

Review date:
August 10, 2012
Reviewed by:
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
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