24 hour ambulatory pH Studies test to see whether gastro oesophageal reflux is present and and whether those reflux episodes can be correlated to symptoms such as chest pain. A thin tube is placed through the nose and gently passed into the lower oesophagus. A special monitor is hooked up to the tube which can measure pH ( to determine how acid the contents of the oesophagus are). Low pH indicates acidity and high pH indicates alkalinity. Some machines will have a button to press to alert the physician reading the study that you were having symptoms at a particular time. When the tracings are analyzed, the physician looks for the number of episodes and the amount of time that the pH of the lower oesophagus is below 3. He or she will also look to see if you were having symptoms at times when you were having episodes of gastroesophageal reflux. 24 hour ambulatory monitoring is currently considered the gold standard to diagnose or confirm a diagnosis of gastroesophageal reflux disease.
Oesophageal manometry is a procedure for determining how well the muscle of the oesophagus works when diseases of the muscle are suspected.
Oesophageal manometry is used primarily in three situations. The first is to evaluate the cause of reflux (regurgitation) of stomach acid and contents back into the oesophagus (gastro oesophageal reflux disease). The second is to determine the cause of problems with swallowing food. The third is when there is chest pain that may be coming from the ooesophagus.
At the start of the oesophageal manometry procedure, one nostril is anesthetized with a numbing lubricant. A flexible plastic tube approximately one-eighth inch in diameter is then passed through the anesthetized nostril, down the back of the throat, and into the oesophagus as the patient swallows. Once inside the oesophagus, the tube allows the pressures generated by the oesophageal muscle to be measured when the muscle is at rest and during swallows. The procedure takes 20 to 30 minutes.