Esophageal pH monitoring is a test that involves 24-hour measuring and recording of the acid levels in the esophagus, also referred to as the food pipe. This test can determine the frequency, duration and intensity of the acid within the esophagus. It can also help determine if a patient has acidic reflux or non-acidic reflux. For patients undergoing evaluation for anti-reflux surgery, the findings from the test will help the gastroenterologist and surgeon determine if surgery will benefit the patient. This test may also be ordered by the gastroenterologist measure the effectiveness of acid suppression medications or anti-reflux surgery on a patient.

Esophageal pH monitoring can be indicated by the gastroenterologist for the following signs and symptoms: esophageal reflux, heartburn, non-cardiac chest pain, reflux esophagitis, Barrett’s esophagus, voice changes and cough due to reflux.

The test starts with the insertion of a very thin catheter with sensors through the nose and into the esopahgus. This catheter is connected to a data recorder on a strap. For the comfort of the patient, a topical anesthetic (lidocaine jelly) is used before the insertion of the catheter. It also helps the catheter pass more easily. Once in place, recording of the acid levels in the esophagus begin. The patient is allowed to go home for the duration of the study. He/she is also given a diary to list important events such as eating, laying down and when symptoms such as heartburn, esophageal reflux and regurgitation occur. The next day, the patient returns to the office to have the catheter removed and the data on the recorder is analyzed.

Starting the test only takes a few minutes, however, once the patient is made to return home for the duration of the test, it will be important for the patient to list down all relevant events that can help the gastroenterologist analyze the findings. The test is minimally uncomfortable as few patients experience gagging and tearing up of the eyes during insertion of the pH catheter.

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