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Old 01-31-2011, 04:31 PM   #1
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Esophageal Motility Test and 24-Hour pH Test

Hello everyone,

I am scheduled for an Esophageal Motility Test and a 24-Hour pH Test next Tuesday. I am a little (okay, maybe a lot would be a better word) worried about the tests, because I have a significant gag reflex. How uncomfortable is the insertion of the tube? And if I am understanding things correctly, it seems that it is a different tube for each test, so I will have to have a tube inserted twice.

Any words of wisdom from those who have had either or both of these tests?

Thank you!!

 
Old 01-31-2011, 07:12 PM   #2
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Re: Esophageal Motility Test and 24-Hour pH Test

I've had two regular 24 hr. pH tests w/ manometries and another pH test just above the UES.

If you get a good technician, they should be able to coach you through the insertion of the tubes. In my case, they numbed my throat and nostrils to lessen the feeling of the tubes being inserted. When they put the tube down into my throat, they had me swallowing water through a straw at the same time to assist with the gagging issue. It isn't too bad if you let nature take its course while swallowing. If you try to fight it, it can be a bit tougher. The technician should be coaching you step by step though to make the process go smoothly.

The manometry tube is first. They will measure your esophageal motility. They will also use this to determine the location of your esophageal sphincters so they know the correct placement of the pH probe. They will then pull that tube out and insert the second probe. The second tube is thinner, but it is a bit more rigid than the first so you might initially feel it a bit more at first. At least then you will know what to expect though.

If you are having acid issues, these are both important diagnostic tests so I highly recommend proceeding with the testing. Just tell yourself "I know I can" to help you get through this.

Good luck,
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Old 02-01-2011, 03:33 AM   #3
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Re: Esophageal Motility Test and 24-Hour pH Test

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Originally Posted by MountainReader View Post
I've had two regular 24 hr. pH tests w/ manometries and another pH test just above the UES.

If you get a good technician, they should be able to coach you through the insertion of the tubes. In my case, they numbed my throat and nostrils to lessen the feeling of the tubes being inserted. When they put the tube down into my throat, they had me swallowing water through a straw at the same time to assist with the gagging issue. It isn't too bad if you let nature take its course while swallowing. If you try to fight it, it can be a bit tougher. The technician should be coaching you step by step though to make the process go smoothly.

The manometry tube is first. They will measure your esophageal motility. They will also use this to determine the location of your esophageal sphincters so they know the correct placement of the pH probe. They will then pull that tube out and insert the second probe. The second tube is thinner, but it is a bit more rigid than the first so you might initially feel it a bit more at first. At least then you will know what to expect though.

If you are having acid issues, these are both important diagnostic tests so I highly recommend proceeding with the testing. Just tell yourself "I know I can" to help you get through this.

Good luck,
MountainReader
i had no idea a manometry had to be performed first, yesterday another user told me about it and now i read this, i'll have to fight to get the manometry first, doctors here don't know what the hell they are doing and my parents do religiously what they say (no wonder im still feeling like crap), im glad somebody made this thread, do they give you any kinda of sedative before doing the manometry and ph monitoring?

Last edited by neptunian808; 02-01-2011 at 03:37 AM.

 
Old 02-01-2011, 02:45 PM   #4
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Re: Esophageal Motility Test and 24-Hour pH Test

Thank you Mountain Reader I will just keep telling myself "Mind over matter, mind over matter." I am used to gagging anyway. I have a chronic cough that often has me gagging to the point of vomitting, so bit of gagging will be nothing new. However, I am a little concerned about my gagging cough while I have the tube in. Every morning I wake up coughing and gagging for about 10 to 15 minutes. Do you think this will cause a problem with the ph tube when I wake up in the morning? I would hate to accidentially dislodge the tube, etc.

Also, I have a medium hiatal hernia. Do you think this will complicate insertion of the tubes?

Neptunian -- I don't think they give any type of sedative as it could slow down the muscle contractions, etc. that they are trying to measure. Mountain Reader would know better than me, though.

 
Old 02-01-2011, 09:48 PM   #5
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Re: Esophageal Motility Test and 24-Hour pH Test

Neptunian: No sedatives. They will spray numbing spray in your throat and nostril. You really don't need more than that. Once the probe is inserted and the computer turned on, you just walk out and go your merry way. They want you to do and eat everything you normally would...they said I could even skydive if I normally would...not many people have that as a normal part of their day though.

seven: My reflux symptom is a horrible chronic cough and sometimes breathing problems. It is really really severe. I have the acid reflux constantly, but my symptom severity flares more at some times than others. When it is at its worse, I'll cough almost non-stop for 4 months at a time. I have trouble breathing, gag and get heaves sometimes (can't vomit most of the time because of my Nissen Fundoplication). While I cough all the time, mornings are my worst. It isn't just 15 minutes for me. Sometimes it is an hour or two before I feel up to heading out to work. This is despite being on double strength PPI's, sleeping on an incline and wataching my diet. I coughed tons while having the test. They will have you log any "symptoms" you have for the 24 hours. Every time you cough, belch, feel heartburn, etc... They will also have you log when you eat and when you are lying down. There will also be buttons on the computer to push when you have symptoms, eat and lie down. When they run your report, they will compare the times of your symptoms to your pH readings.

For the traditional 24 hr pH, the tube goes down your nose, throat and esophagus all the way down until just above your LES. (for a dual probe one will be placed above your UES). It isn't going to go anywhere. They will tape the tube to your cheek to keep it from accidently being pulled up. Then they wrap it around the back of your ear. The first times you swallow solids, you will feel a bit of a "tug". You will get used to it though. Don't it let affect what you are eating. Make sure you eat "normally" so the results show true. Coughing won't make any difference in the tube. You will just need to hit the computer button when you start and stop coughing.

The gagging could be tough if you let it. Focus instead of swallowing...like when you swallow a large pill. Just swallow your water (or whatever they give you) over and over. If you keep swallowing, you are having your natural movements help get the probes down.

The hernia shouldn't make a difference. The probe will probably be completely above it. I had one as well during my first 2 probes with no problem. (My 3rd probe was after my surgery.)
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Old 02-02-2011, 06:35 AM   #6
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Re: Esophageal Motility Test and 24-Hour pH Test

Just try to stay calm. Thats the Key. They manometry is a large tub and uncomfortable but if you stay calm it will be ok. It takes about 10 mins to do test. The ph sensort is a breeze, worst part is when your eating and swallowing its a little uncomfortable. Try not to eat too much dry food like bread and foods that are hard to swallow. They will pull a little on sensor.

Just keep telling your self that these tests are important and it will be over in 24 hours.

They really will tell alot about your condition and take the guessing out of whats going on with you.

 
Old 02-03-2011, 07:11 PM   #7
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Re: Esophageal Motility Test and 24-Hour pH Test

Thank you Mountain Reader. So sorry about your cough. Did the surgery help your cough? That is my main symptom also. I rarely have heartburn unless I eat something I shouldn't. The double-strength PPI's did nothing for my cough either.

Debbie

 
Old 02-03-2011, 07:14 PM   #8
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Re: Esophageal Motility Test and 24-Hour pH Test

Thank you gpinzone. I have heard that these tests are the gold standard for diagnosis, so I will keep telling myself that. I figure what is one day of discomfort compared to 10 years of feeling sick every day. These tests may just be able to help me find the answer to my problem. Debbie

 
Old 02-03-2011, 07:22 PM   #9
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Re: Esophageal Motility Test and 24-Hour pH Test

With the Nissen, my cough stopped coxmpletely immediately post-surgery. Unfortunately, I'm back to having asthma related reflux problems with gaseous acid coming up. Not sure how to stop that.

I'd still have the surgery again in a heartbeat though because my coughing and breathing issues had become lifethreatening.

I wish you well on your tests.
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Old 02-08-2011, 06:26 AM   #10
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Re: Esophageal Motility Test and 24-Hour pH Test

Well I survived the insertions and am now home with my pH monitor. It was basically as everyone described -- not fun but not too terrible. The motility test was definitely the harder of the two. The worst part now is that it is making up nose stuffy.

So my pH has been holding steady at around 1.6. That is really acidic, isn't it? When I ate, it actually went up to 5.0 (I would have thought it would be the other way around).

Thank you everyone for all your help. It was not as bad as I expected.

Debbie

 
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Old 02-08-2011, 06:45 AM   #11
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Re: Esophageal Motility Test and 24-Hour pH Test

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Well I survived the insertions and am now home with my pH monitor. It was basically as everyone described -- not fun but not too terrible. The motility test was definitely the harder of the two. The worst part now is that it is making up nose stuffy.

So my pH has been holding steady at around 1.6. That is really acidic, isn't it? When I ate, it actually went up to 5.0 (I would have thought it would be the other way around).

Thank you everyone for all your help. It was not as bad as I expected.

Debbie
Your ph is at 1.6? OMG are you sure? 1.6-2.0 is the ph of your stomach acid. Thats bad. There should be two readings one for the sensor near your LES and one near you UES. They should both be over 5.0

 
Old 02-08-2011, 07:05 AM   #12
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Re: Esophageal Motility Test and 24-Hour pH Test

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Your ph is at 1.6? OMG are you sure? 1.6-2.0 is the ph of your stomach acid. Thats bad. There should be two readings one for the sensor near your LES and one near you UES. They should both be over 5.0
Mine only has one pH reading. Right now it says 1.8. I am not sure if the sensor is near the LES or the UES. Funny thing is I rarely have heartburn. My main symptom is an unrelentingly chronic cough.

 
Old 02-08-2011, 07:32 AM   #13
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Re: Esophageal Motility Test and 24-Hour pH Test

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Mine only has one pH reading. Right now it says 1.8. I am not sure if the sensor is near the LES or the UES. Funny thing is I rarely have heartburn. My main symptom is an unrelentingly chronic cough.
What kind of test did the Dr. order for you? The only one you should be taking is a dual impedance test that has two sensors one to measure PH by your LES and one to measure by your UES. Dual meaning two sensors impedance meaning it measures both acid and non acid reflux events.

The only way to place the sensors properly is to do a manometry to see how long your esphogus is. Its a good sign they did that. what is the name and model and make of the ph tester? I know when they first do the test they put the sensor in your stomach to get the ph of your stomach acid which again is 1.5-2. If your stomach acid is higher thats a problem as you may not have enough acid to digest foos properly.

This is going through your nose, correct? I never heard of a cathoder based sensory that goes through your nose that only has one sensor. ITs possible the data is stored on box and it's not capable of reading the sensors in realtime on the control panel and what you are seeing is your stomach acid? I

I hope for your sake thats the case. I would call the Dr's office and ask. Whats the point of going through the discomfort if its not going to give you the data you need to properly diagnoise your condition.

BTW what was the outcome of the manomerty?What is the pressure of your UES and LES? Anyone swallowing abnormalities?

 
Old 02-08-2011, 07:48 AM   #14
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Re: Esophageal Motility Test and 24-Hour pH Test

They did not say anything about my mamnometry being abnormal. Apparently, they are going to send all the results to my ordering physician. In this case, the ordering physician was my ENT as I went to him about my cough. He is apparently well-versed in laryngeal sensory neuropathy, which is what I thought might be going on. i developed my cough after an URI about ten years ago.

The monitor is a Sandhill Scientifics Sleuth. It has one reading called pH1. It is through the nose. I have a button to push for cough, nausea, and heartburn.

Maybe that is the pH of my stomach. It seems awfully acidic to be the pH of my esophagus. I could understand a few episodes of acid, but the number has basically stayed between 1.3 and 1.6 all morning, so maybe it is the stomach. If not, well then I guess I know what my problem is!

 
Old 02-08-2011, 08:28 AM   #15
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Re: Esophageal Motility Test and 24-Hour pH Test

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Originally Posted by sevenseas831 View Post
They did not say anything about my mamnometry being abnormal. Apparently, they are going to send all the results to my ordering physician. In this case, the ordering physician was my ENT as I went to him about my cough. He is apparently well-versed in laryngeal sensory neuropathy, which is what I thought might be going on. i developed my cough after an URI about ten years ago.

The monitor is a Sandhill Scientifics Sleuth. It has one reading called pH1. It is through the nose. I have a button to push for cough, nausea, and heartburn.

Maybe that is the pH of my stomach. It seems awfully acidic to be the pH of my esophagus. I could understand a few episodes of acid, but the number has basically stayed between 1.3 and 1.6 all morning, so maybe it is the stomach. If not, well then I guess I know what my problem is!
I googled them It looks like they are capable. If I were you google them and see if the devices on thier website are the same as they one you have. Also If you had 1.5 ph then that would mean your LES isnt working at all but you would have heartburn all the time. The picture shows lcd screen a few buttons. If thats your you may be able to hit a button a few times to scroll between sensors.

 
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