Esophageal pH monitoring

Esophageal pH Monitoring

A pH probe used in esophageal pH monitoring

Esophageal pH monitoring is a diagnostic procedure used to measure the pH or acidity level in the esophagus over a 24-hour period. This test is primarily used to diagnose gastroesophageal reflux disease (GERD) and to evaluate the effectiveness of medications that prevent acid reflux.

Procedure

The procedure involves the insertion of a thin, flexible tube through the nose and into the esophagus. This tube, known as a pH probe, is equipped with a sensor that measures the pH level. The probe is connected to a small recording device worn on the patient's belt or shoulder.

File:Bravo tracing.jpg

Bravo pH monitoring system tracing

In some cases, a wireless pH monitoring system, such as the Bravo system, may be used. This involves attaching a small capsule to the lining of the esophagus during an endoscopy. The capsule transmits pH data to a receiver worn by the patient.

Indications

Esophageal pH monitoring is indicated for patients who:

• Have symptoms of GERD that do not respond to treatment
• Are being considered for antireflux surgery
• Have atypical symptoms such as chronic cough, laryngitis, or asthma suspected to be related to acid reflux

Interpretation of Results

The data collected from the pH probe is analyzed to determine the frequency and duration of acid reflux episodes. The DeMeester score is a commonly used metric to quantify acid exposure in the esophagus.

The DeMeester score takes into account several factors, including the total time the pH is below 4, the number of reflux episodes, and the duration of the longest episode. A score above a certain threshold indicates abnormal acid exposure.

Complications

Esophageal pH monitoring is generally safe, but some patients may experience discomfort from the probe. Rare complications include nasal bleeding, sore throat, or esophageal perforation.

Related Pages

• Gastroesophageal reflux disease
• Endoscopy
• Antireflux surgery
• DeMeester score