How to Prepare for Esophageal pH Monitoring
Location of Procedure
Inova Alexandria Hospital Patient Services Center Endoscopy Suite
Purpose of the Procedure
Esophageal pH monitoring measures the acidity, or pH, of the esophagus over a 24-hour period. It measures how much acid enters the esophagus, which also is known as the swallowing tube or food pipe, from the stomach.
The procedure is used to evaluate heartburn, gastroesophageal reflux disease, esophageal scarring, reflux esophagitis and dysphagia (a late symptom of esophageal scarring).
Equipment
This exam uses a thin tube called a catheter, which is placed in the esophagus. The tube will protrude from the nose and connect to a small, portable, one-pound monitor you will wear on a strap.
The monitor records pH measurements on an ongoing basis, enabling your physician to evaluate whether the level of acidity in your esophagus is normal over a 24-hour period of time.
Preparation
To properly prepare for your exam and ensure accurate results, you may need to make changes to your daily routine. Your physician or nurse will inform you of specific instructions. Please refer to this guide as directed by your physician or nurse.
- Inform your physician or nurse of your allergies and medical problems.
- Do not use the following medications
for at
least seven days before your
exam:
- AcidPhex (rabeprazole), Axid (nizatidine), Donnatol, Levsin (hyoscyamine sulfate), Nexium (esomeprazole magnesium), Pepcid (famotidine), Prevacid (lansoprazole), Prilosec (omeprazole), Protonix (pantoprazole sodium), Reglan (metoclopramide), Tagamet (cimetidine), Zantac (ranitidine hydrochloride)
- Do not drink beverages with caffeine, such as coffee or soda, for at least seven days before your exam.
- You may take over-the-counter antacids up to 24 hours prior to your exam including Maalox, Mylanta, Gaviscon or Tums.
- Do not eat or drink any food or liquids (including candy, lozenges and chewing gum) for eight hours before your exam.
- Certain medications should be continued prior to your exam, including heart and high blood pressure pills. You may continue to take these medications with small sips of water.
- Wear a garment to your appointment that fastens in the front and can be easily removed at bedtime.
First Appointment
The catheter will be inserted into your nostril and positioned in your esophagus. You may feel slight pressure in your nostril and gag as it is inserted. Once it is in place, the sensation will subside. The tube will remain in your esophagus for 24 hours.
Directions for Your 24-hour Study
Follow these directions for your 24-hour study:
- Go about your normal activities, including your regular diet, work, recreation and sleep. If you know how to bring on your symptoms you are encouraged to do so.
- Press the "event" button on your recorder once at the beginning and end of your meal, snack or drink, as well as when you begin to feel any symptoms.
- Adjust the button on the side of the recorder as follows: slide it down when you lie down and slide it up when you sit or stand up.
- There are no diet restrictions - follow your regular diet and activities. Avoid constant drinking or snacking for long periods of time. You may drink beverages with meals or with between meal snacks. Do not chew gum or suck on hard candies or lozenges.
- Do not recline during the day and at night sleep flat with one pillow.
- Do not take any antacids or gastrointestinal medications unless instructed otherwise.
- Do not take a bath, shower or swim.
Caring for the Recorder
- Keep the recorder on your body at all times (at bedtime you may place it under your pillow or at the bedside).
- Keep the recorder in its case.
- Do not drop or mistreat it.
- Do not get it wet.
- Do not detach it or turn it off.
Potential Side Effects
You may experience side effects:
- The passage of the tube into the esophagus may cause retching or vomiting.
- nasal drainage (you may blow your nose as usual)
- The tube may move slightly (this will not interfere with breathing or eating).
- sore throat
- minor nasal discomfort and/or bleeding
Second Appointment
You will return to the hospital for a second appointment 24 hours after your first appointment so the tube may be removed and you can return the monitor.
Your physician will analyze the information recorded on the monitor.
