Esophageal pH Monitoring (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- What is esophageal pH monitoring?
- When is esophageal pH monitoring used?
- How is esophageal pH monitoring performed?
- How is esophageal pH monitoring used?
- What are the limitations of esophageal pH monitoring?
- Are there other ways in which pH monitoring can be used?
- What are the side effects of esophageal pH monitoring?
- Are there alternatives to esophageal pH monitoring?
- Find a local Gastroenterologist in your town
Are there other ways in which pH monitoring can be used?
If the pH sensor is left in the stomach instead of the esophagus, it is possible to determine the effectiveness of medications that shut off the production of acid in the stomach. This information may be useful in determining the proper doses of medications among patients with acid-related conditions of the stomach and duodenum (for example, peptic ulcers). It also is possible to place a catheter with two acid sensors so that one sensor is in the stomach and the other is in the lower esophagus. With this catheter, it is possible to evaluate both acidic esophageal reflux and the effectiveness of acid-suppressing medications.
The pH sensor may be placed in the upper esophagus or in the pharynx just above the upper esophageal sphincter in patients with unexplained symptoms of sore throat, hoarseness, or cough. In these patients, the demonstration of acid reflux into the upper esophagus or pharynx suggests that acid reflux may be the cause of the symptoms. Recent studies however have shown that the association of these symptoms with acidic reflux may not be reliable.
What are the side effects of esophageal pH monitoring?
There are very few side effects of esophageal pH monitoring. Although there may be mild discomfort in the back of the throat while the catheter is in place, particularly during swallows, the majority of patients have no difficulty eating, sleeping, or going about their daily activities. Most patients, however, prefer not to go to work because they feel self-conscious about the catheter protruding from their nose. The capsule device may cause discomfort when swallowing. The discomfort is felt in the chest and may be due to food or the wave of esophageal contraction tugging on the capsule as it passes.
Are there alternatives to esophageal pH monitoring?
There are no alternatives for obtaining the information that esophageal pH monitoring provides. Nevertheless, the presence of esophagitis visually at the time of endoscopy strongly suggests the presence of acidic reflux among patients who don't have other likely causes of esophageal pain. This may obviate the need to do a pH monitoring study.
Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine
Madan, Kaushal, et. all. "Impact of 24-h Esophageal pH Monitoring on the Diagnosis of Gastroesophageal Reflux Disease: Defining the Gold Standard." Medscape.com.
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