University College Hospital
Oesophageal manometry
and pH recording
Gastrointestinal Services Division
Physiology Unit
Author: Dr Anton Emmanuel, Consultant Gastroenterologist
First published:
September 2012
Last review date:
February 2015
Next review date:
February 2017
Leaflet code:
UCLH/S&C/GI/PHYSLGY/MNMETRY&pH/1
© University College London Hospitals NHS Foundation Trust
Created by Medical Illustration RNTNEH 020 3456 5103 Unique Code: 28977
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Space for notes and questions
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How to find us
The GI Physiology Unit is on the lower ground floor of the EGA wing.
If you need a large print, audio or translated copy of the
document, please contact us on 020 3447 9130.
We will try our best to meet your needs.
Contents
Introduction
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What are manometry and pH / impedance recording?
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How do these tests help?
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What are the risks of having these tests?
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What will happen if I choose not to have the tests?
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What alternatives are available?
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How should I prepare for these tests?
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Asking for your consent
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What happens during the tests?
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What should I expect after the tests?
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Where can I get more information?
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Contact Details
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How to find us
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Space for notes and questions
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Where can I get more information?
Information about gastro-oesophageal reflux disease (GORD) is readily
available from many places, including your GP, pharmacy, hospital
gastroenterology department or online at: http://www.cks.nhs.uk
Note: This website is provided for information and education purposes
only. No guarantees or warranties are made regarding any of the
information contained within this website.
Contact Details
This information leaflet tells you about achalasia but if you have read the
leaflet and have any queries please contact the GI Physiology Unit.
Address:
GI Physiology Unit
University College Hospital
Lower Ground Floor, EGA Wing
235 Euston Road
London, NW1 2BU
Telephone:
020 3447 9130
(Monday to Firday 09:00 to 17:00)
Switchboard:
0845 155 5000 or
020 3456 7890
(All other times)
Fax:
020 3447 9258
Email:
[email protected]
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Due to the fact that the tube will be visibly taped to your face, you may
wish to make changes to your daily routine; this however is entirely your
decision and no changes to your normal day are necessary for the test.
It is important that the tube stays in position throughout the study.
It is very unlikely to come out by accident or when you are asleep but
you should take care that it is not pulled out by mistake (for example
by children or pets). The tube will remain in place for approximately
24 hours and will be removed quickly and easily the next day when
you return to the department.
What should I expect after the tests?
You will not be sedated and therefore you will be able to travel home
and continue with your normal activities immediately after the test.
This leaflet gives you all the relevant contact numbers and addresses
should you have any problems.
The results of the tests will be put into a report which will be reviewed
by the Unit consultant and then sent to your referring doctor. A copy
will also be saved onto the hospital system and sent to you and to your
GP. When you return to see your doctor (for example at the outpatient
clinic at UCH, at another hospital, or your GP surgery) the test results
and any appropriate treatment will be discussed with you.
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Introduction
The gullet (oesophagus) is the muscular tube which allows food to pass
down from your mouth into your stomach. When the stomach contents
(which may be acidic) wash back up from your stomach into your gullet,
this is called acid reflux. A small amount of reflux is normal but too
much acid reflux typically causes heartburn and indigestion and may
also cause less typical symptoms such as difficulty swallowing, chest
pain, hoarseness, sore throat and cough. Your doctor has referred you
for these tests because you are experiencing some of these symptoms.
The tests allow us to measure reflux and may help to determine if this is
the cause of your symptoms.
What are manometry and pH / impedance recording?
These tests are used to find out if there is a problem with your gullet.
Manometry involves putting a thin plastic tube into your gullet to record
pressure; in this way we can investigate how the gullet moves. pH
recording allows us to record acid which comes up from your stomach
into your gullet (acid reflux).
How do these tests help?
These tests are used to determine (diagnose) if you have excessive
reflux, as your doctor suspects that this may be the cause of your
symptoms. It can be of help because a firm diagnosis may help your
doctor to treat you in the best way possible and therefore help to
relieve your symptoms.
What are the risks of having these tests?
We will discuss with you any possible discomfort associated with this
procedure before it is commenced. However, although having a tube
inserted into your nose may feel uncomfortable and strange, there are
no risks or adverse effects from the procedure. This means that there
may be some discomfort but the procedure can not cause you any harm.
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What will happen if I choose not to have the tests?
Asking for your consent
As with most tests, these tests form one part of the jigsaw of information
which the doctor requires in order to treat you. If you do not wish to
undertake these tests for any reason, we will simply let your doctor know
and although it would be useful to have this information they will continue
to treat you as well as possible without it.
You will not be asked to sign a consent form to undergo this test. The
test will be explained to you fully when you come to the department
and you will have the chance to ask any questions that you might
have. Please do not hesitate to ask questions or voice any worries.
If you decide to go ahead with the test, you are confirming that you
agree to have the test and understand what it involves.
What alternatives are available?
pH recording can also be undertaken using a wireless capsule (Bravo®
pH recording) which is implanted during an upper GI endoscopy and
records acid reflux for 48 hours. This test is not carried out at this
centre and although there is less discomfort in the nose it may lead
to some discomfort in the chest and can only be put in place during
an endoscopy. If you are interested in this test you should speak with
your GP or the referring doctor.
How should I prepare for these tests?
These tests are outpatient procedures which do not require any
sedation and you will not need to be accompanied to the hospital.
You must not have anything to eat or drink (except for water) for two
hours before your appointment.
If we need to ask you to stop any medication you might be taking, you
will find the necessary information enclosed with this leaflet and your
appointment letter. The information is entitled “Preparation instructions”.
Please follow this carefully.
If you have not received such an attachment with your letter this means
that you do not have to do anything else prior to attending and you
should continue to take all of your current medication as you
would normally.
What happens during the tests?
You will sit comfortably on the side of the bed with your chin tilted down
slightly. A thin plastic tube (manometry catheter) will pass through your
nose, into your gullet, and down to your stomach. As the tube goes
down it may cause your eyes to water and you may retch and cough but
the procedure is not painful and once the tube is in place you should
feel more comfortable. Your breathing will not be affected. You will then
be asked to lie on your side on the bed and you will be asked to swallow
some water, so that the movement of your gullet can be recorded. This
takes approximately 15 minutes in all and the tube is then removed
quickly and easily.
Following this you will be asked to sit up and another tube, which
records acid (pH catheter), is passed into your gullet in the same
way as before. Once in place this is taped securely to your nose and
remains in place for 24 hours. The end of the tube comes out of your
nose and is taped behind your ear and is then attached to a small
recording box worn on a shoulder strap or on your belt. Whilst the
tube is in place your nose may run a little and you may experience a
little discomfort in your nose and throat particularly when you eat.
As we need to record what is happening over a 24 hour period, you
will leave the hospital with the catheter remaining in your nose. During
the study, you can go about your normal activities: you should be able
to eat, drink, move about and sleep as usual. You can wash as long
as the recording box does not get wet.