24-Hour Esophageal pH Test

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What is an esophageal pH test?
An esophageal pH test measures and records the pH in your esophagus to determine if you have gastroesophageal reflux disease (GERD). The test can also be done to determine the effectiveness of medications or surgical treatment for GERD.

What is esophageal reflux?
Esophageal reflux is a condition in which stomach acid refluxes or moves back into the esophagus (the "food pipe" leading from the mouth to the stomach).

What happens during esophageal reflux?
A specialized muscle, called the lower esophageal sphincter, is located where the esophagus meets the stomach (see figure). This sphincter opens to allow flood and liquid to pass into the stomach, then closes. When the sphincter does not close tightly, food particles, stomach acid and other digestive juices can splash back up into the esophagus. When this happens, the condition is called gastroesophageal reflux. When reflux occurs on a regular basis, it can cause permanent damage to the esophagus. The esophageal pH test measures how often stomach contents reflux into the lower esophagus and how much acid the reflux contains.

How does the esophageal pH test work?
A thin, small tube with an acid sensing device on the tip is gently passed through your nose, down the esophagus ("food tube"), and positioned about 2 inches above the lower esophageal sphincter. The tube is secured to the side of your face with clear tape. The end of the tube exiting from your nose is attached to a portable recorder that is worn on your belt or over your shoulder. The recorder has several buttons on it that you will press to mark certain events. A nurse will review the monitoring instructions with you.

How do I prepare for the 24-hour esophageal pH test?

  • Seven days before the monitoring period, do not take proton pump inhibitors: Prilosec (omeprazole), Prevacid (lansoprazole), Aciphex (rabeprazole), Protonix (pantoprazole), Nexium (esomeprazole)
  • Two days (48 hours) before the monitoring period, do not take the H2 blockers: Zantac (ranitidine), Tagamet (cimetidine), Pepcid (famotidine), Axid (nizatidine); or the promotility drug, Reglan (metoclopramide)
  • Six hours before the monitoring period, do not take antacids (such as Alka-Seltzer, Gaviscon, Maalox, Milk of Magnesia, Mylanta, Phillips, Riopan, Tums or any other brands)
  • Four to 6 hours before your appointment do not eat or drink

Please note: Occasionally, your doctor may want you to continue taking a certain medication during the monitoring period to determine if it is effective.

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Last Updated: 12/2/2008

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