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Oesophageal pH

Overview

Oesophageal pH Test is a diagnostic test performed to identify a condition called Gastroesophageal reflux (GERD) or acid reflux. It is also called Bravo test. The oesophagus is a muscular tube in the human digestive system. It carries food and liquids from the throat to the stomach. Typically, the lower oesophageal sphincter (LES) which is like a valve prevents the stomach acid from flowing back into the oesophagus. However, when the LES malfunctions, acid reflux can occur, leading to discomfort such as heartburn and potentially causing long-term damage to the oesophagus. In such cases, the oesophageal pH test is used to determine how often and for how long stomach acid enters the oesophagus.

An oesophageal pH test may be recommended by your doctor if you have the following conditions:

  • Heartburn: Persistent or frequent heartburn that may suggest acid reflux as the underlying cause.
  • Difficulty swallowing: A sensation of food or liquid getting stuck, which can result from acid-induced scarring in the oesophagus.
  • Chest pain: Unexplained chest pain that may be linked to acid reflux
  • To assess treatment effectiveness: The test can help evaluate how well treatments for acid reflux are working.
  • Diagnostic clarification: It can be used alongside other tests, such as an upper GI series or endoscopy, to provide a clearer picture of the condition of the ossiphageous.

As a preparation for the oesophageal pH test, patients are asked not to consume anything for at least 8 hours before the test. Some medications can influence the test results. Patients should discuss their medications with their doctor, who may advise discontinuing certain drugs at least 48 hours before the test.

Medications that may need to be stopped include caffeine (coffee, tea, soda, chocolate), alcohol, Reglan, Urecholine, Erythromycin, Nitroglycerin, and others like calcium channel blockers, beta blockers, and antacids such as Tagamet, Zantac, Prilosec, and others.

The procedure is typically quick and can be performed on an outpatient basis. It involves the following steps:

  • The patient is asked to be seated or lie on their side for the procedure.
  • A soft, thin tube is inserted through the nose or mouth and gently passed down into the oesophagus.
  • The tube is connected to a small portable device that records the pH levels in the oesophagus throughout the test.
  • The test usually lasts 12-24 hours, during which time the patient is asked to continue with their usual activities.
  • The test measures stomach acid in the oesophagus. Normal results show infrequent reflux, while abnormal results suggest acid reflux issues, guiding treatment options.

The oesophageal pH test is highly beneficial because it provides specific data about the amount and duration of acid reflux, allowing for precise treatment decisions. Some key benefits include:

  • The test helps tailor treatment strategies based on the severity of acid reflux.
  • If the results are normal, it can reassure both the doctor and patient that acid reflux is not the cause of symptoms.
  • It helps evaluate the effectiveness of treatments, such as proton pump inhibitors (PPIs), in controlling acid reflux.

While other diagnostic methods like an upper GI series or endoscopy are useful, they do not provide the same level of insight into acid reflux as the pH test. The pH test is often paired with oesophageal manometry (a test that measures oesophageal pressure) for a more comprehensive evaluation.

Despite the fact that the test is generally secure, there are a few potential side effects, such as:

  • Gagging: A minor sensation of gagging may be experienced during the insertion of the tube. Breathing techniques are typically effective in managing it.
  • Mild Discomfort: The tube may cause mild discomfort or congestion in certain patients following the procedure.
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