NHS Oesophageal Manometry and 24hr pH Monitoring Instructions

NHS Oesophageal Manometry and 24hr pH Monitoring

Information for Patients

You have been asked to attend an appointment at the hospital to have some tests carried out to investigate the function of your stomach and oesophagus. The test will take approximately 1 hour.
Please read these instructions carefully.

What do I need to do before?

• Please do not eat or drink for 2 hours before your appointment, unless you are diabetic then please eat as normal.
• If you should suffer with asthma, please continue to use your inhalers as normal and bring them with you.
• Please continue to take any epilepsy or heart medication as normal. If you are having a 24-hour pH monitoring study, you will need to stop taking certain medications before. You can resume all medications once the test is complete and 24-hour catheter is removed.

7 days before please stop taking:

• Losec (Omeprazole
• Protium (Pantoprazole)
• Zoton (Lansoprazole)
• Pariet (Rabeprazole)
• Nexium (Esomeprazole)
• Azid (Nizatidine)

3 days before please stop taking:

• Zantac (Ranitidine)
• Motilium (Domperidone)
• Cisapride (Prepulsid)
• Maxalon(Metaclopramide)
• Tagamet (Cimetidine)
• P

24 hours before and during, please stop taking:

• Gaviscon
• Rennies
• Bisodol
• Tums
• Mucogel
• Algicon
• Maalox
• Buscopan
• Spasmonal
• Nifedipine
• Asilone
• Topal
• Any simple pharmacy antacid preperations
  Please continue with all other medications prior to your appointment.

FAQ

• Why are these tests necessary?

  • These tests provide valuable information regarding the function of your stomach andoesophagus. It can help your doctor manage your symptoms and decide medication or your future management. There are no less invasive investigations that are able to provide the same equivalent clinical information.
  • Oesophageal manometry assesses the strength and function of the muscles and valves in your oesophagus whilst you swallow. Typically a 24-hour pH monitoring study will also be completed following manometry. This helps to evaluate the cause and nature of your symptoms.

• Are the tests painful?
  The tests should not cause you any pain and you will not need sedation. You will however have the feeling of a ‘lump’ in your throat during the tests. Your throat may feel slightly rough or uncomfortable for a short time after the test.

• What will happen during an oesophageal manometry study?

  • Upon arrival, the clinician will describe the procedure and you will have an opportunity to ask questions. At the start of the procedure you will be sat upright. A soft thin catheter with pressure sensors will gently be inserted up your nose, past the back of your throat and down your oesophagus into your stomach. You will not be sedated in any way and you will be able to talk and breathe normally throughout. It is not painful and any mild discomfort from the catheter being inserted should quickly pass.
  • After intubation you will be asked to lie down on the couch and you will be given time to get used to the catheter before the assessment begins. The clinician will then ask you to swallow small amounts of saline at various intervals whilst measurements are made. At the end of the test, you will be sat up and the catheter will be removed.

• What will happen during a 24hrs pH monitoring?

  • In the same manner as the manometry test, an even smaller catheter, with sensors, will be gently inserted up your nose, past the back of your throat and down into your oesophagus. This catheter is much thinner and generally more comfortable than the one used during oesophageal manometry. It will remain in place for the duration of the test (about 24 hours). The catheter will be taped to your cheek, passed around your ear, taped at the neck and attached to a small recorder which is worn on a shoulder strap or on a belt around your waist.
  • The clinician will explain which buttons on the recorder to press each time you eat, sleep or experience symptoms. You will also be asked to complete a diary detailing this and the time when each occurs.
  • Once you leave your appointment you will be encouraged to carry on with your normal activities as much as possible. You will be aware of the catheter during the 24-hours however most patients find it becomes less noticeable with time. Whether you go back to work or not, please try and be as active as you normally would be. Please try to eat and drink as normally as possible with the catheter in place, but avoid acidic (e.g. fruit juices), carbonated (fizzy) or alcoholic drinks as these can cause false readings.

Removing the pH probe

• If you have had 24-hour pH monitoring, the catheter will be removed for you when you return the following day for a 10 minute appointment. Removal of the catheter only takes a few seconds and is completely painless.
• Whilst not expected, if you do need to remove the catheter yourself:
  • You should be sitting upright
  • Remove the tape securing the catheter to your nose.
  • Smoothly pull the catheter out while breathing out through your nose.
  • The probe should NEVER be cut.
  • If it cannot be easily removed, you should go to the A&E department for assistance.

What are the risks and side effects of these tests?
Oesophageal manometry and 24-hour pH monitoring are considered very safe and complications are rare.

• There may be some mild temporary discomfort that causes your eyes to water as the catheter is inserted up your nose.
• Some patients may experience a nosebleed. This is usually brief and the test can continue once this has stopped.
• As either catheter passes down the back of your throat, this may briefly trigger your gag reflex. If this causes you to feel unwell or light headed, the clinicians looking after you will be able to help. This typically eases quickly once the catheter is in place.
• After a 24-hour pH study some patients may experience a sore throat, nosebleed, runny nose or a hoarse voice. These symptoms should settle within 24 hours.
• If you are pregnant, please inform us prior to your appointment.
  If you have any questions or concerns about this test please contact the GI Physiology team on 01225 824023 or ruh-tr.hegip-info@nhs.net and we will be happy to help.

ABOUT COMPANY

• Royal United Hospitals Bath NHS Foundation Trust Combe Park, Bath, BA1 3NG
• 01225 428331
• www.ruh.nhs.uk
• Please contact the Patient Advice and Liaison Service (PALS) if you require this leaflet in a different format, or would like to feedback your experience of the hospital.
• Email ruh-tr.pals@nhs.net or telephone 01225 825656.

References

• Royal United Hospitals Bath

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