What is an oesophageal pH catheter?
This catheter is a fine piece of tubing which contains three sensors at the distal end. The tube is placed through the nose and the tip lies in the stomach and the sensors record changes in the gastric and lower oesophageal (gullet) acidity.
The catheter stays in position for 24 hours and gives continuous feedback via hard wiring back to the data recorder worn at your waist and to a neutral electrode taped to the chest wall.
What is the point of this study?
Acid reflux from the stomach to the gullet may cause symptoms of chest pain, cough, and throat irritation but at endoscopy the gullet may look normal. Often these symptoms are poorly responsive to medications although anti-reflux surgery may be helpful. This pH monitoring study may help determine if acid reflux is causing these symptoms.
More about the study
The catheter is placed in a fasting patient usually at the Day Surgery Unit. It is a simple procedure which takes about 5 minutes and then you go home to return in 24 hours for removal. The tube is then removed in 3 seconds, and the information from the data recorder is downloaded onto the computer and the report will be sent to your referring doctor within the week.
Is the catheter uncomfortable?
It can be an uncomfortable sensation as the catheter is positioned through the nose but it takes only a few minutes to get into the right position and then the body adapts to the feeling. At home try to behave as normally as possible, eating your usual diet and going about your usual activities. I do ask you to avoid showering or engaging in heavy physical activities while wearing the electrical equipment. If the reference electrode peels off tape it on again please.
Should I take my acid suppressant medication?
Usually no. Please STOP your Losec, Nexium, Pariet, Acimax, Zoton, Somac, Zantac, Rani 2 etc, 48 hours before the study (on rare occasions I will ask you to continue these tablets during the study).
The catheter is in place but what are all these buttons on the black box?
There are 3 buttons on the data recorder.
Meal: Press at beginning and end of a meal
Sleep: Press at beginning and end of a rest period when lying down
♥Event: This red heart button is the most important. Press this button immediately if you experience chest pain, heartburn, sore throat and cough. If a relationship can be demonstrated between your symptoms and acid reflux seen on the trace then a useful diagnosis can be made. Sometimes the event marker does not mark the trace clearly and it is a wise idea to keep a diary the day of the study. Record your meal times, resting time and symptoms using the time displayed on the data recorder.
Do not turn the box off! The nurse in the Day Surgery Unit will do this when you present 24 hours later to have the catheter removed. After the catheter has been removed you may resume your usual medications.
What are the risks associated with this procedure?
This procedure is very safe. The catheter is small and usually does not interfere with breathing. The most common problems are nausea and irritation of the nose and the back of the throat. The incidence of serious complications is very low, less than one in 10,000 procedures. There is a remote possibility of bleeding, perforation (making a hole) or infection. Death is a remote possibility with any interventional procedure. A number of rare side effects may occur with any interventional procedure.
Download the following pdf file if required.
Patient Oesophageal pH Monitoring Consent