Sara459-
I too went through long bouts of chronic coughing which began in December of 2001. I went through a lot of trial and error with my PCP to find a combination of things that worked. I was on Protonix for a couple years which helped some, but the cough kept coming back. I finally went to the GI specialist. The cough was my main symptom with occassional belching. I never had any heartburn though. I first had an endoscopy that showed no evidence of acid--my esophogus and stomach looked fine. I was then advised to get the manometry and 24 hr PH. Even though I didn't want the tube down my throat for that long, I was willing to do it if it could help figure out if acid was actually a problem for me.
I went in at 8:30 in the morning with an empty stomach. It was a technician who performed the procedures. The manometry was done first. It measures how well my esophogeal sphincter was working and also gives an exact location of the sphincter which allows them to know where to place the 24 hr. probe. For the manometry, I had the back of my throat numbed with a spray that tasted across between bananas and gasoline (it tasted exactly like the technician said-luckly the taste didn't linger). I was asked which nostril was the least stuffy. He used that side to do the testing. The nostril was numbed with a gel. After they had a couple minutes to take effect, the technician placed a tube through the nostril and had me swallow water through a straw to help the tube down my throat. It was uncomfortable, but it didn't hurt. It helps to relax. The tube was connected to a computer. The technician moved the tube up and down in small intervals to take readings. He also had me swallow water about 12 times so he could get readings on how well the sphincter was working. Once he was done he pulled out the tube. This was done in one quick pull and didn't hurt.
Once the Manometry ws completed, he moved on the the PH probe. This was a different tube. It was smaller than the first tube by about 1/3. For me this one was a bit more uncomfortable when he inserted it. The technician said it was a bit stiffer than the first tube. There are numbers on the tube that help the techician know how far the tube goes down based upon location of the sphincter from the manometry. Once the tube was down, he taped it to my nose and cheek and wrapped it around my ear. The tube ended at a round computer that took measurements of reflux throughout the day. There were a couple buttons on the computer that I had to touch whenever I ate or laid down. I was also given a piece of paper to mark every time I had a symptom during the day. This helps them know what activities I was doing during periods of reflux. At first, I found myself swallowing a lot with the tube in my throat. I guess it was just an automatic response to having something foreign there. Also, occassionally when I was eating, I could feel a tug on the probe. It didn't hurt though. I was instructed to go to work and do all normal daily activities with the probe in so they could get a good reading. This wasn't fun, but then everyone I work with had been putting up with my cough for years (they always knew when I was coming down the hall by my cough). I went in the next morning and it only took a few seconds to have it removed. The only other thing I didn't really like was that I couldn't shower. I just went home after I got it out the next day to shower though. I went back in about a week later to get the results.
I was glad I had the tests done, because it confirmed that I did have acid reflux. I found my esophogeal sphincter was not closing properly and I had acid in my esophogus 25% of the day normally and 35% of the time when I was eating. This was while I was already following the prescribed diet of avoiding items that aggrevate acid reflux. I now have my bed propped and take Prevacid 2X per day.
By the way--I think it would also be helpful to go to the allergist. It turns out I needed to be treated for allergies, PND, asthma, and GERD before I got my cough under control. It took me years to find the right balance, but I have now been cough free for almost two months and counting.
I know this response was long, but I hope it helps.
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