Oesophageal manometry
and 24-hour pH monitoring
Delivering the best in care
UHB is a no smoking Trust
To see all of our current patient information leaflets please visit
www.uhb.nhs.uk/patient-information-leaflets.htm
Instructions for oesophageal manometry and
24-hour pH monitoring
Prior to the test:
Please do not eat or drink for 3 hours before test (unless you
are diabetic then please eat as normal).
If you should suffer with asthma, please continue to use your
inhalers as directed by your GP.
If you take medication for your heart, please continue to take
this as directed by your GP.
Please stop taking the following antacid medication seven days
prior to the tests:
Losec (Omeprazole)Protium (Pantoprazole)
Zoton (Lansoprazole)Pariet (Rabeprazole)
Nexium (Esomeprazole)Axid (Nizatidine)
Please stop taking the following medication three days prior to
the tests:
Zantac (Ranitidine)Maxalon (Metaclopramide)
Tagamet (Cimetidine)Cisapride (Prepulsid)
Motilium (Domperidone)
Please stop taking the following medication 24 hours prior to
the tests:
GavisconTumsMucogelAlgicon
RenniesMaaloxBuscopanSpasmonal
BisodolNifedipineAsiloneTopal
Any simple antacid preparations from your local pharmacy.
2 | Oesophageal manometry and 24-hour pH monitoring
Oesophageal manometry and 24-hour
pH monitoring
You have been asked to attend an appointment at hospital
to have some tests carried out to investigate the functioning
of your stomach and oesophagus (gullet). The tests will take
approximately 30 minutes.
What is the oesophagus?
The oesophagus is a long muscular tube which connects the
mouth to the stomach. Between the lower end of the oesophagus
and the stomach there is a special sphincter muscle (a valve). The
valve opens to allow food and drink to pass into the stomach but
then closes again to prevent the stomach contents regurgitating
(refluxing) back in to the oesophagus.
What is the function of the oesophagus?
Its function is to pass chewed food and liquids from the mouth
to the stomach by progressive muscular contractions.
TEST 1 – oesophageal manometry
What is the test for?
The test is used to check that the nerves and muscles of the
oesophagus are functioning properly. The test will also check
that the valve at the top of the stomach is of normal pressure
and opens and closes correctly.
How is the test carried out?
Your nostril will be sprayed with a short lasting freezing agent to
stop you sneezing and minimise discomfort.
A thin tube is passed gently around the inside of your
nose. You will then be asked to drink a beaker of water through
Oesophageal manometry and 24-hour pH monitoring | 3
a straw, this will help the tube to move through the throat and
down the oesophagus into the stomach.
You will be able to breathe normally at all times during the
procedure.
Once the tube is in place you will feel a ‘lump’ sensation in your
throat. It is not painful, just a little uncomfortable and should
settle down quite quickly.
You will then be asked to lie down on your back on a couch with
one pillow.
In order to measure the muscles of the oesophagus, we will
attach the other end of the tube to a recorder for a period of
10 minutes. You will be asked to be still and quiet with relaxed
breathing.
You will also be asked to swallow small mouthfuls of water at
regular intervals until the test is complete.
TEST 2 – 24-hour pH (acid) monitoring
What is the test for?
This test allows us to measure the amount and severity of acidic
stomach contents that maybe leaking-up from the stomach into
the oesophagus.
These measurements are taken for a 24-hour period so that we
can see what happens after your meals and at night when you
are asleep.
The test will also show us how well your symptoms are related to
the presence of acid in your oesophagus.
How is the test carried out?
Your nostril will be sprayed again with a short lasting freezing
agent to stop you sneezing and minimise discomfort.
A thin tube with a small probe on the end is gently passed
4 | Oesophageal manometry and 24-hour pH monitoring
around your nose. You will be asked to drink a beaker of water
through a straw, this will help the tube to move through the
throat and down the oesophagus.
You will be able to breathe normally at all times.
Once the tube is in place you will feel a ‘lump’ sensation in your
throat. It is not painful, just a little uncomfortable and should
settle down within 30 minutes.
This time the end of the tube will be positioned in the
oesophagus, above the stomach.
The tube will be taped securely to the outside of your nose,
passed around your ear and attached to a small recording box
which is worn on a shoulder strap or on a belt around your waist.
You will be given a set of instructions before you leave and will
be asked to fill in a special diary of your meals, bedtime and
symptoms.
You will be sent home and be able to eat, sleep and carry out
your normal daily routines.
You will return the following day to have the tube removed.
Removal of the tube takes a few seconds and is painless.
Oesophageal manometry and 24-hour pH monitoring | 5
Frequently asked questions
What is the benefit of having these tests done?
The main benefit of the tests is that the physician has clear
documentation of the muscle function of the oesophagus and
the degree of acid reflux. Using the information from these tests
your physician can plan any treatment that you may require or
provide reassurance if the tests are normal.
What are the risks and side effects of these tests?
• Oesophageal manometry and 24-hour acid monitoring tests
are generally very safe. The tests may cause slight discomfort
in the nose and the throat but should not be painful. The
discomfort can be minimised by spraying the nostril with local
anaesthetic.
• You may also feel slightly sick when the tube is first positioned
in the oesophagus but this should settle down quite quickly.
• Other side effects of these tests are minor and can include a
mild sore throat, nosebleed, a runny nose, vomiting, fainting
or wheezing. However, these side effects can be easily and
quickly dealt with at the time.
• There is a very small risk that the probe could damage the
oesophagus however, this is very unlikely as the catheter
is flexible and the GI Physiologist who does the test has
specialised training and is very experienced.
• During the tests, the majority of patients are able to eat and
sleep as normal and go about their daily activities. However,
some prefer not to work because they feel self-conscious
about having a tube coming out of their nose.
• If you have any allergies, please inform the GI physiologist who
does your test before the test begins.
• Please inform your GI physiologist by telephone if you are
pregnant, prior to your appointment.
6 | Oesophageal manometry and 24-hour pH monitoring
Are there alternatives to oesophageal manometry and
24-hour acid monitoring?
Nothing can take the place of oesophageal manometry and
24-hour acid monitoring. However, other studies are used to
investigate other aspects of oesophageal function, the results
of which will provide complimentary information. For example,
an Endoscopy can be carried out to view the lining of the
oesophagus or a barium swallow will allow viewing of the
anatomy of the swallowing muscles and oesophagus.
Will the test be painful?
The tests are not painful and you will not need sedation. However
you will have the feeling of a ‘lump’ sensation in your throat
whilst the tube for each test is in position. Your throat may feel
slightly rough or uncomfortable for a short time after the test.
This can be eased by gargling with salty water.
Is the probe safe?
Please do not worry, the probe is very small and safe. Even if you
sneeze, cough or vomit, the probe will not come out.
Are there any special instructions for after the tests?
• You may go back to your normal routine
• You will be able to drive afterwards if you wish
• You can eat and drink as normal
• When you have returned after 24 hours to have the second
tube removed you may restart any medication that we may
have asked you to stop
When will I get my results?
The readings of your tests will be analysed by your physiologist
(an expert in how the body functions) and the results will be sent
to your consultant. Your consultant will then discuss the results
with you at your next clinic appointment.
Oesophageal manometry and 24-hour pH monitoring | 7
Hintles
Metch
ley Park
Road
Mindelsohn
Nuffield
House
Way
Metc
hley
Lane
48,
98, 99
4
Fisher
House
University
Station
48, 98, 99
www.uhb.nhs.uk
Morris
Sports
Centre
Old Queen Elizabeth Hospital
P
Visitor / Pat
2
3
Medical School
48,
98, 99
Shuttle
48, 98, 99
Harb
Car Parking
Charges
Ha
rb
Ho
£2.70
£4.00
£4.60
£5.30
£6.00
£6.60
£13.30
£18.60
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riv
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Old QE Pa k D
– Car Parient
THQ
Haematology
OPD
Shuttle
Cancer
Centre
Post
Graduate
Centre
Info Desk
Main Entrance
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48,
64,
76,
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84, 98, 99,
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647
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3 hours
4 hours
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Weekly Pass
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Pa
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Ro
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Mindelsohn Way
Way
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Minde
Aston Webb Boulevard
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ham A
A&E
Birmingham
Women’s Hospital
CDU
1
TAXI
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Mindels
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64, 76
84, 98
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Queen Elizabeth Hospitals
99, 647
Staff
Car Park F
Shuttle
P
New QEHB Parking
– Car Park A
Shuttle
Visitor and Patient
48, 99, 647
Outpatients
New Queen Elizabeth
Hospital Birmingham
Staff
Car Park
B1
s fo
64, 76
84, 98
Mindels
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Shuttle
Harborn
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Selly Oak
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Busy Bees
Nursery
Access to Busy
Bees and Staff
Car Park F only
48, 99
647
48,
647
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Harborn
Appointment Letter Map. Correct at 23 October 2013.
The Oleaster
(BSMHFT)
The Barberry
(BSMHFT)
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For all appointments in the Outpatients area of
the new Queen Elizabeth Hospital Birmingham,
please enter through the main entrance 1 and
check in using the self check-in kiosks.
3
All wards &
departments (old
hospital)
11, 48
Selly
Oak
Bris
ham
ing
8
Birm oad A3
en
nc
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Parking on the Queen Elizabeth Hospitals site
When visiting our hospitals we recommend the
following car parks:
For the new Queen Elizabeth Hospital
Birmingham use Car Park A (sat nav postcode
B15 2WB – please note this takes you to
Mindelsohn Way and will only work if you have
updated your sat nav. When on the hospital site,
please follow signs for Car Park A)
Outpatients & all
wards/departments
(new hospital)
East Block Day Unit
Drop-off only
4
Disabled Parking
Gibbins Road
61, 63, 64
Foss
e Wa
y
New
For the Old Queen Elizabeth Hospital use Car
Park D (sat nav postcode B15 2TH)
1
Cancer Centre
Hospital entrances
2
Parking
Taxi rank
Bus Stop – Centro /
West Midlands Travel
Pedestrian Route
The shuttle bus is a free
service to transport
patients and visitors
to various locations
around the site. The
service runs from
07:00-19:00 MondayFriday (excluding Bank
Holidays).
Key
P
TAXI
61, 63, 64
Fo
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PI13/0374/06 UHB/PI/0374 Author: Joanne Hayes
Date: March 2014 Review date: March 2016
e Lane