2023-05-30 14:08:32
The esophageal pHmetry is a medical examination which makes it possible to diagnose a possible gastroesophageal reflux (RGO) and to assess the degree of severity of the latter.
A test that detects reflux of stomach acid into the esophagus
pHmetry measures the acidity level in the esophagus. The lower the pH detected, the more acidity there is, which is a sign of persistent gastroesophageal reflux disease (GERD).
As a reminder, gastroesophageal reflux (GERD) corresponds to the rise of part of the gastric contents into the esophagus. It is a normal physiological phenomenon when it is intermittent (occurring in particular following meals, at night and in certain positions such as when we lean forward). Nevertheless, GERD is regarded as pathological when it persists, intensifies causing inflammation of the lining of the esophagus (esophagitis).
Other possible complications of GERD areesophageal ulcerthe esophageal strictureBarrett’s esophagus (endobrachyœsophage) or a esophageal cancer.
pH of the esophagus: what standards in adults?
Usually the Normal mucocutaneous pH in both adults and children is understood between 5 and 7. Thus a reflux of gastric acid from the stomach to the esophagus lowers the pH of the latter. It is believed that there is a acid reflux when the esophageal pH is less than 4.
pHmetry and pH-impedancemetry
pHmetry can be associated with a pH-impedancemetry. This examination records the movement of liquids in the esophagus in order to detect the possible presence of reflux independently of the acidity level of the environment. This examination therefore makes it possible to diagnose gastroesophageal reflux even with low acidity.
Esophageal pHmetry and Manometry
These latter examinations may be accompanied by a esophageal manometry intended to measure the pressure in the esophagus for a period of 30 to 45 minutes, thanks to a probe equipped with a sensor. This technique makes it possible to record the contractions and relaxations of the cardia and to verify that these movements are normal.
Indications: when to do a 24-hour pHmetry?
A pH metry might be prescribed by your doctor in several cases:
· In case of suspicion of gastroesophageal reflux due to typical (such as heartburn) or atypical (reflux, cough, hoarseness, sore throat, dental erosion, etc.) persistent symptoms. In this case, the doctor will find out if you are suffering from acid reflux in order to treat it and avoid complications.
· In case of’failure of anti-reflux treatmentin order to readjust the treatment or consider surgery.
In order to prepare a surgery to treat reflux or a lung transplant.
Procedure: how does a pHmetry work?
pHmetry is performed on an outpatient basis. The patient is lying down in order to introduce a probe through his nostril. The probe is slid from the nose down the esophagus to the stomach. In order to facilitate the insertion of the probe, the patient may be asked to swallow while drinking water through a straw. The probe is fixed at the level of the wing of the nose and connected to a recording box positioned at waist level.
The patient can then go home with the probe for a period of 24 hours. The objective is to detect the possible presence of acid reflux and to identify its main characteristics (time of onset, link with the symptoms experienced, etc.).
During the examination, the patient continues his usual activities and eats normally. He must note the symptoms felt as well as the moment of their appearance. The recording device should not get wet. The patient cannot take a shower or a bath for 24 hours. It is recommended to wash with a washcloth.
Once the treatment is finished, the patient must return to his doctor at the time indicated so that the probe and the case can be removed.
The patient can leave the doctor’s office alone following the pH measurement. He can take public transport and he must remain vigilant not to be bothered by the probe if he is driving.
pHmetry: is it painful?
pHmetry is an unpleasant examination that sometimes requires a local anesthesia at the level of the nostril. Catheter placement and wearing may cause embarrassed or a burning sensation.
The catheter generally does not affect the quality of life. The only downside is that the probe is visible. You can continue with your usual activities and even go to work (unless your professional activity risks having the catheter ripped out or you do not want to go to work with your catheter visible).
What is the duration of the pHmetry?
The placement of the probe takes regarding 30 minutes. Then, the probe remains in place for 24 hours (duration of the recording). Then the removal of the catheter takes only 5 minutes. The data recorded for 24 hours will then be analyzed by a gastroenterologist doctor.
pHmetry: how to prepare for the exam?
To carry out a pHmetry, it is necessary:
To be with an empty stomach for at least 4 hours before the exam. Drinking is permitted up to two hours before the exam.
· D’stop your antacid treatment for a period of 7 days before the examination.
· On the day of the examination, it is recommended to wear loose clothing on the upper body and which open in front (blouse, shirt, etc.).
Are there any contraindications to pHmetry?
There is no contraindications to pHmetry apart from:
- the existence of a recent bone fracture in the face;
- discomfort in the ENT pathways or esophagus which prevents placement of the probe (deviation of the nasal septum, cold, sinusitis, etc.).
What are the risks of side effects from pH measurement?
pHmetry is a risk-free examination. However, some side effects are possible:
- a burning sensation or a slight discomfort at the level of the ENT pathways or the esophagus is possible at the time of placement of the probe and therefollowing;
- sometimes a slight bleeding from the nose or throat may occur;
- a local reaction to the anesthetic (if used) is possible;
- a bitterness in the mouth may occur while wearing the catheter.
pHmetry: what results?
The results are delivered by the doctor who observes the trace of the pHmetry. pHmetry quantifies acid exposure in the esophagus. It records episodes of reflux and any concordance with the symptoms experienced by the patient. A pH drop below 4 corresponds to an episode of acid reflux.
Positive pH-metry: what to expect?
In the event of a positive diagnosis of GERD following a pHmetry, a anti-reflux treatmentmight be administered. GERD can be treated with anti-reflux drugs (proton pump inhibitors, anti-H2…). If a treatment was already prescribed, it might be adjusted or surgery might ultimately be considered in order to treat GERD more effectively.
Where to do a pH metry?
The pH metry is performed on an outpatient basis in a medical office by a gastroenterologist doctor.
pHmetry: what price to expect?
The 24-hour esophageal pHmetry has a cost of 86,40 €. These costs are covered by social security. In addition, you will be asked during the examination to purchase a probe necessary for the examination from the pharmacy. This probe costs €55 and is currently not covered by Social Security.
1685523220
#pHmetry #examination #esophagus
