Esophageal pH-measurement is a test that is performed when gastroesophageal reflux disease is suspected. It measures the concentration of hydrogen ions (acidity) in the lower esophagus. How is esophageal pH measurement done and what are the other indications for the test?

Esophageal pH measurementis a test that can help confirm or rule out gastro-oesophageal reflux disease, i.e. the reflux of gastric acid into the esophagus. It measures the concentration of hydrogen ions (acidity) in the lower esophagus using a special probe that is inserted through the nose. Thanks to the probe, you can find out how much gastric acid flows back from the stomach into the esophagus and how long it stays there.

oesophageal pH-measurement - indications and contraindications for the test

Esophageal pH measurement measures the acidity in the lower esophagus.

  • suspected gastroesophageal reflux disease
  • symptoms such as pain and burning behind the breastbone that cannot be explained
  • recurrent upper respiratory tract infections, chronic cough and hoarseness of unclear causes (gastroesophageal reflux disease may be disguised as respiratory infections)
  • as a pre-procedure for gastroesophageal reflux surgery

The test is not performed in people with severe coagulation disorders or esophageal obstruction. The test may also be impossible to perform in people with oesophageal ulcers, varicose veins, or multiple large esophageal diverticula.

esophagus pH - how to prepare?

The last meal should be eaten 4-6 hours before the test to minimize the risk of vomiting while inserting the probe. In addition, some medications may need to be discontinued before the test. Proton pump inhibitors should be discontinued 7 days before the examination, and drugs affecting gastric secretion and prokinetic drugs should be discontinued for 2 days. In turn, you cannot take antacids for the 24 hours before the examination.

Esophageal pH - what is it?

The doctor locally anesthetizes the nasal and throat mucosa. Then he inserts a probe through the nose into the esophagus, at the end of which is a measuring electrode. Then the electrode is connectedto the recorder (weighs about 300g), which the patient wears on the belt during the examination.

During the examination, changes in the final esophagus pH are recorded over 24 hours with measurements taken every 4 seconds.

The test takes 24 hours. During this time, the patient carries out normal daily activities (except bathing and showering). Besides, he keeps a diary in which he writes:

  • start and end eating meals
  • start and end of each lying position
  • development of heartburn or chest pain or other disturbing symptoms

After 24 hours, the probe is removed and the data from the recorder is sent to a computer that calculates the test results using special software.

oesophageal pH measurement - complications

The most common symptom of the patient's throat irritation is that it wears off. In rare cases, spontaneous nose bleeding may occur.

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