I've been having burning and lots of stomach issues since taking antibiotics for h. pylori. Finally decided to go to a different doctor. Next week I have an endoscopy/colonoscopy scheduled along with a 24 hour ph monitor. I know it will be good to find out but I'm really anxious about all of this. How does the ph testing work? Is that fairly uncomfortable?
Hi there AJ. Truthfully, 'fairly uncomfortable' sums it up. As far as the PH testing, you probably can't help some anxiousness going in and remind yourself of the thousands who have put up with it, and find things to do to keep yourself busy while wearing the catheter.
If you are suspecting LPR, make absolutely sure they are giving you a DUAL PROBE catheter, not just the one that will sit above your LES. The results with only that may give your GI doc reason to argue there is acid coming up into your throat but -- I advise this because it turned out in my case they did not do the two probes (the second is placed right before the UES) and I don't want you to be frustrated as I have been. I learned that my manometry is ok, and there were many, mostly acid refluxes with just a few non acid, hitting the lone distal probe. But, while some inference is possible, the whole idea is to prove there is acid coming all that way up (if that is your concern -- if you don't have throat issues, not to worry)
For sure do not eat a thing for the time you are told, maybe 12 hours fast prior to the test and catheter install.
During the manometry catheter install you may have to work just a little with your gag reflex, but the technician will have seen it all before and be there for you and be patient for you. In my case I got through that part fairly easily... but it's not a ton of fun. I expect they will test your swallowing and esophageal function which they have to do to properly place the probe. You will lay back and swallow a little water and have to not swallow for thirty seconds, a little hard to do but it will be over soon.
Then probably they will install a smaller catheter for the 24 hr monitoring. You will definitely feel it and remind yourself that the sucker is coming out the next morning. One curious phenomena is a kind of tugging feeling after swallowing food, that is your peristalsis and LES opening and closing, as if there is a tiny fish in you stomach nibbling on a line -- weird! But not alarming you know what is happening. If you have sleeping aids, why not use them if your doc is not opposed... I have apnea and use a CPAP, so I had a chance to use my full face mask and surprised myself getting through the night without waking. I was totally ready for that thing to come out!
It's not getting your lungs ripped out, or getting a bone reset or anything painful and awful it's just possibly uncomfortable. You will be told to go about your normal activity which will make you and your friends laugh... and remember you are doing science and you hope to learn something. You'll be ok!
The scope is no big deal. Slept through the whole thing, woke up fine. For the pH monitoring, they have to leave it in place. It is somewhat uncomfortable. Some people find it very uncomfortable, others are fine with it.
Don't go hiking up mountains, but do stay busy. 24 hours will pass quicker than you think. And soon, your doctor will have plenty of information, so he can treat you more effectively!
The endoscopy and colonoscopy aren't bad. They typically have you sleeping during the procedures and you won't feel a thing. I've had three endoscopies and one colonoscopy and have found that I felt quite good after the procedures. The worst part of the entire procedures is when they put the needle in for the IV and that really isn't that bad.
I've had 3 24 hr pH tests and 2 Manometries as well. White having the tube inserted involved a bit of discomfort, I didn't find it all that bad. They will typically numb the nostril you choose to use and may spray something to numb the back of your throat as well. (If they do that, it tastes a bit of a cross between gasoline and banana, quite disconcerting.) The technician will give you a glass of water and straw to sip on while the tubes are inserted. They will guide you through the procedure and have you take sips of water to help you "swallow" the tube. If you focus on swallowing, the gag reflux shouldn't be too bad. I did find the manometry tube a bit stiffer than the pH test one so there was a bit more discomfort with it, but it still wasn't too bad.
They will connect you to a small computer which will monitor your pH level. You will push a button to register when you eat, lay down, or have a reflux "incident". They tell you to make sure you follow your regular routine throughout the 24 hour period. My tech told me that I could skydive if I wanted to.... I do want to caution that at first you will notice a "pull" when you swallow food with it in. It isn't too bad and you will become used to the feel.
The first time I had the test done, I was embarrassed going out with it in public. The last couple times, I changed my perspective. The test is a necessary step in figuring out exactly what is going on and I decided it really didn't make any difference what other people thought. That helped me to follow my nnormal routine.
Honestly, I wouldn't have allowed the second or third test if the test was that unpleasant. If it was warranted again, I would go ahead with it without question. I will say the results over the period of a couple years were very very telling in my case.
Hi Mountain Reader, wow! You have had a lot of testing! I hope things are stable for you these days. I was wondering if you were ever given the barium swallowing test. The reason I ask is my LPR symptoms are steadily improving with the current round of Omeprazole twice/day and GERD diet, finally giving up coffee (and perversely, having a lot of alcohol the other night -- go figure!) -- and I am finding the times I am most prone to a catch in my throat sensation now is drinking a swallow of plain water. I am not sure of the mechanics of this, if it is a swallowing thing or that plus some of the regular suspects, LES relaxation, etc...
My 24 hr PH test results showed a lot of acid events above the LES coinciding with burping, but they apparently didn't do the second probe in the throat.
I am trying to build on my improvements though with a little slippery elm paste, and inhaling a oinch of vegetable cellulose, the closest I can get to the effect of the Koufman product that has not made it yet to market. Call me crazy but... maybe it helps...
Anyway, I was curious as to what you ever learned about your swallowing...
My story with all its ups and downs can be tracked through my posts on this board. I think I started posting on here around 2007/2008. I started with general GERD in 2002 which I kept controlled with PPI's once a day and diet for years. Then it gradually got worse and I developed LPR. I kept that under control with PPI's twice a day and diet for years. Then the PPI's gradually started losing effectiveness. I didn't realize what was happening for a long time because my symptoms were attributed to my asthma, allergies and sinus issues.
It was actually my Pulmonologist who referred me for a Modified Barium Swallow and Esophagram after the first time I saw him. The Esophagram showed my swallowing process was working correctly. The Modified Barium Swallow showed I had acid coming up into my throat and that I was aspirating some acid into my lungs as well. In getting my LPR under control, I ended up working with the Pulmonologist, my Gastroenterologist, my ENT and my PCP. I should justify that my reflux was classified as extremely severe and the steps I took over the years were atypical for the average reflux sufferer. I'm currently on Dexilant 60mg, and my reflux symptoms are completely under control.
If you are truly looking for a test that measures the acid coming up above your upper esophageal sphincter, the best test is an upper pH test by ResTech which is the only test that will measure the gaseous reflux coming into your throat. It takes very little acid to irritate the throat and a typical probe doesn't have the same sensitivity. I actually received that test through my ENT.
thanks for the info on ResTec... I will file that, right now hanging on with the Omeprazole, sure wish there were other approaches to get things in sync and toned and working normally again as do we all huh! Thanks for your story, all best -- B