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Esophageal Motility
pH Probe Testing


pH Probe Testing

24 hour pH probe       Bravo 48 hour pH probe

What is a 24 hour pH probe?

A 24 hour pH probe is a procedure whereby a thin, flexible catheter is placed into the esophagus through the nose. The catheter is connected to a recorder worn on the belt. A 24 hour pH probe study is performed to look for abnormal amounts of acid within the esophagus. A 24 hour pH probe may be ordered by your physician in order to evaluate for gastroesophageal reflux disease (GERD), help determine the cause of chest pain, or prior to esophageal surgery.

What should I expect the day before the procedure?

You will receive instructions from your doctor regarding the necessary preparation . Most patients will be allowed to eat normally the day before the exam. Patients will be instructed not to take anything by mouth after midnight except for medications. It is very important to follow the instructions given to you by your doctor. There will also be additional instructions regarding your medications. In most cases, your medications will be continued as usual. However, in certain circumstances, especially in patients on blood thinners (i.e. coumadin, warfarin, plavix, aspirin, and antiinflammatories) and in diabetics, special instructions will be given.

What happens on the day of the procedure?

You will be asked to arrive at the Endoscopy center 30 minutes before your exam. This is to allow time to fill out paper work and prepare for the exam.

Once in the procedure room, you will be asked to lie on an exam table. One of the nostrils will be numbed with lidocaine. The nurse will then place a thin catheter into the nostril. As the catheter is advanced into the esophagus, you will be asked to swallow to help open up the esophagus. Once the catheter is in appropriate position it will be connected to the recorder. Overall, the exam will take approximately 15-30 minutes.

Because there is no sedation for the exam, you will be allowed to leave the endoscopy unit as soon as you are finished. Most patients are able to eat and drink normally after their discharge from the endoscopy unit, however, specific instructions regarding activity, eating, and medications will be given to the patient prior to discharge.

Because the probe measures the pH of the esophagus for 24 hours, you will need to return to the endoscopy unit the following day to have the pH probe removed.

When will I get my results?

Because the computer must generate graphs and tables from the data obtained during the exam, results of the test will not be available while you still at the endoscopy unit. The test results will be interpreted by the physician at a later time. You should be contact by the doctor's office within a week with the exam results.

What are the risks of the exam?

The 24 hour pH probe is a very safe procedure. Complications occur in less than 1% of patients. Most complications are not life-threatening, however, if a complication occurs, it may require hospitalization and surgery. Prior to the exam, a consent form will be reviewed with the patient by the nursing staff.

Perforation or puncture of the esophagus is a very uncommon complication, but can occur. This may be recognized at the time of the exam, or it may not be apparent until later in the day. In most cases, a perforation will require a surgery and hospitalization.

It is very important that the patient contact the doctor's office immediately if symptoms arise after the procedure such as worsening abdominal pain, bleeding, or fever.

Like any other test, a 24 hour pH probe is not perfect. There is a small, accepted risk that abnormalities can be missed at the time of the exam. It is important to continue to follow-up with your doctors as instructed and inform them of any new or persistent symptoms.

What are alternatives to a 24 hour pH probe?

To an extent, the alternatives to the exam will depend on the reason for needing to undergo the 24 hour pH probe in the first place. The only other alternative to measuring the pH of the esophagus is the Bravo 48 hour pH probe.

What is a Bravo 48 hour pH probe?

A Bravo 48 hour pH probe is a procedure whereby a small pH monitor is attached to the bottom part of the esophagus via a thin catheter introduced through the mouth. Once in place, the monitor is detached from the catheter which is then removed. Thereafter the monitor will transmit its data to a wireless recorder worn on the belt for the following 48 hours. Within a few days of completing the procedure, the pH monitor will spontaneously detach from the esophagus and pass out the digestive tract.

The purpose of the study is to look for abnormal amounts of acid within the esophagus. A 48 hour pH probe may be ordered by your physician in order to evaluate for gastroesophageal reflux disease (GERD), help determine the cause of chest pain, or prior to esophageal surgery.

Often an esophagogastroduodenoscopy (EGD) is performed to help place the esophageal monitor.

What should I expect the day before the procedure?

You will receive instructions from your doctor regarding the necessary preparation . Most patients will be allowed to eat normally the day before the exam. Patients will be instructed not to take anything by mouth after midnight except for medications. It is very important to follow the instructions given to you by your doctor. There will also be additional instructions regarding your medications. In most cases, your medications will be continued as usual. However, in certain circumstances, especially in patients on blood thinners (i.e. coumadin, warfarin, plavix, aspirin, and antiinflammatories) and in diabetics, special instructions will be given.

What happens on the day of the procedure?

You will be asked to arrive at the endoscopy center 30-60 minutes before your exam. This is to allow time to fill out paper work and prepare for the exam.

If no endoscopy is performed with the pH probe the exam will only take 10-15 minutes. The back of the throat will be numbed with lidocaine. A catheter will be placed into the mouth and down into the esophagus. Once in the correct position, the pH monitor will be attached to the lining of the esophagus and the catheter will be removed.

Because there is no sedation for the exam, you will be allowed to leave the endoscopy unit as soon as you are finished. Most patients are able to eat and drink normally after their discharge from the endoscopy unit, however, specific instructions regarding activity, eating, and medications will be given to the patient prior to discharge.

Because the probe measures the pH of the esophagus for 48 hours, you will need to return to the endoscopy unit in two days to return the recorder. The esophageal monitor will fall off on its own and pass out with the stool.

If an esophagogastroduodenoscopy (EGD) is performed to help place the pH monitor, the EGD will be performed first. While still under sedation, the pH monitor will be placed as above.

When will I get my results?

Because the computer must generate graphs and tables from the data obtained during the exam, results of the test will not be available while you still at the endoscopy unit. The test results will be interpreted by the physician at a later time. You should be contact by the doctor's office within a week with the exam results.

What are the risks of the exam?

The 48 hour pH probe is a very safe procedure. Complications occur in less than 1% of patients. Most complications are not life-threatening, however, if a complication occurs, it may require hospitalization and surgery. Prior to the exam, a consent form will be reviewed with the patient by the nursing staff.

Perforation or puncture of the esophagus is a very uncommon complication, but can occur. This may be recognized at the time of the exam, or it may not be apparent until later in the day. In most cases, a perforation will require a surgery and hospitalization.

Patients can develop chest pain after the monitor is attached. This does not occur in the majority of patients, but if it does, pain medications will be provided.

Rarely, the pH monitor will not fall off on its own. If this occurs, an esophagogastroduodenoscopy (EGD) may need to be performed to remove the monitor.

It is very important that the patient contact the doctor's office immediately if symptoms arise after the procedure such as worsening abdominal pain, bleeding, or fever.

Like any other test, a 48 hour pH probe is not perfect. There is a small, accepted risk that abnormalities can be missed at the time of the exam. It is important to continue to follow-up with your doctors as instructed and inform them of any new or persistent symptoms.

What are alternatives to a 48 hour pH probe?

To an extent, the alternatives to the exam will depend on the reason for needing to undergo the 48 hour pH probe in the first place. The only other alternative to measuring the pH of the esophagus is the 24 hour pH probe .

 

 

 

 

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