24-hour pH monitoring study

What is a 24-hour pH monitoring study?

This is a procedure which measures how often fluid refluxes (flows back) into your oesophagus from your stomach and the pH of this fluid over a 24-hour period. This will tell your doctor whether your symptoms are caused by acid reflux. The procedure is also used before any operation to treat anti-reflux (fundoplication).

What are the possible side effects, risks or complications?

The common side effects of this procedure can include a:

• runny nose (while the tube is being inserted)
• sore throat (up to 24 hours)
• slight discomfort on swallowing.

Very occasionally, some patients may feel faint during the procedure. There is also a very small risk of this procedure causing other complications such as bleeding from damage or perforation to:

• the inside of your nose
• your throat
• your larynx (voice box)
• your oesophagus
• your stomach.

Careful monitoring (checking) by your doctor or specialist nurse will make sure any problems are identified and treated quickly.

What should I do before my procedure?

Unless you have been instructed to specifically continue your medication;

10 days before your procedure you must stop taking medication such as omeprazole (Losec), lansoprazole (Zoton), esomeprazole (Nexium), rabeprazole (Pariet), pantoprazole (Protium), or cimetidine (Tagamet).

3 days before your procedure you must stop taking other medications such as ranitidine (Zantac) and Gaviscon.

If you have diabetes, please contact your diabetic nurse for advice. (See contact numbers).

On the day of your procedure you must:

• not eat anything after midnight
• not drink any fluids after 7.00am
• continue to take all your normal medication except any antacids (unless you have been specifically told to continue them)
• wear comfortable, loose clothing.

What will happen when I arrive at the hospital?

Your appointment letter will tell you when and where to attend for the procedure. When you arrive at the unit, your nurse will make sure you understand what is involved in the procedure and will answer any questions you may have.

What will happen during the procedure?

Your nurse will make sure you are comfortable. You will be asked to sit upright and some local anaesthetic spray will be sprayed inside your nose to numb the area.

Your nurse will then pass a thin plastic tube up the inside of your nose. This tube will pass through your nose and down your throat until it reaches the bottom of your oesophagus. To help the tube pass smoothly through your nose and throat you may be asked to sip and swallow some water. For this reason, sedation cannot be given for this procedure.

Once the tube is inserted a piece of tape is used to hold it in place on your nose and face. It is then placed behind your ear and connected to a small recording box, attached to a belt around your waist. The tube will not move, even if you cough or blow your nose.

You will be aware of the tube in the back of your throat and this may feel a little uncomfortable.

The recording box measures the pH of any fluid that refluxes into your oesophagus. You will be shown how to use this, as you will need to press some buttons when you eat, lie down or have any of your symptoms.

The insertion of the tube should take about 10 minutes. You will then be allowed to go home for 24 hours while still wearing the small recording box. You will be asked to keep an accurate diary sheet for the 24-hour period to allow you to record more information about your symptoms.

At the end of the 24-hour period, you will need to return to have the tube removed. This should take around 5 – 10 minutes.

Can I carry out my normal activities during the 24-hour recording period?

Yes, as it is important to record what happens to you during a normal day; you can continue with most of your usual activities, including eating and drinking. You may go to work as normal. When you go to sleep you must remove the belt and place the recording box next to you or under your pillow.

During the 24-hour recording period you:

• must not chew gum, or have peppermint sweets or drinks
• must not have any fizzy drinks
• must not have any acidic foods, for example, vinegar or orange juice
• must not have any citrus fruits, such as, lemons, limes or oranges
• must not have a shower or a bath (as the water could damage the recording equipment)
  
• must not take any indigestion medication, for example, omeprazole (Losec), Lansoprazole (Zoton), esomeprazole (Nexium), rabeprazole (Pariet), pantoprazole (Protium), cimetidine (Tagamet), ranitidine (Zantac), Gaviscon, or Rennies, as these will make the results inaccurate and the procedure will need to be repeated, unless otherwise instructed to do so.

What if I cannot tolerate (cope with) the tube any longer?

If, at any point during the 24-hour period, you feel you cannot tolerate the tube any more you can simply pull the tube out. To do this you should remove the tape on your nose, take a deep breath and gently pull the tube out. You should put the tube in a bag and return it and the recording box to the hospital. If this happens we may not have enough information about your condition.

If you vomit (are sick) and the end of the tube moves from the oesophagus to the back of your mouth, remove the tube as described above.

When will I know the results of the test?

The results will be sent to the consultant in charge of your care who referred you for this procedure. He or she will discuss these with you at your next outpatient appointment.

Contact numbers

If you need further advice, or have any problems, please contact the appropriate number below:

University Hospital of Hartlepool

Rutherford Morison Unit

telephone: 01429 522356

Monday – Friday, 8.00am – 6.30pm

Diabetes Liaison Nurses

Telephone: 01429 522594

Monday – Friday, 9.00am – 5.00pm

Accident and Emergency Department

telephone: 01642 382899

24 hours a day, 7 days a week

If you have any worries or concerns, you should contact your GP during normal surgery hours. Outside surgery hours you should contact your GP’s surgery for the Out of Hours Service number.

Further information is available from:

NHS Choices

telephone: 111 (when it is less urgent than 999)

Calls to this number are free from a landline and mobile phones via the website at www.nhs.uk

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]

Leaflet Reference: PIL1241
Date for Review: 18/09/2023