This test is important for diagnosing reflux and related conditions, as it measures acidic or non-acidic reflux over a testing period of 24 hours.
Measuring the volume and severity of acid in the stomach and how much of this leaks from the stomach back into the oesophagus, helps to determine a possible cause for your symptoms and the future management of these.
You may be sent for this test if you have reflux symptoms such as heartburn, belching, chest pain, cough, or regurgitation caused by stomach contents coming up into the oesophagus.
This test reflux procedure is often performed in combination with oesophageal manometry and is one of the most accurate tests for identifying acid reflux and GERD.
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What does a reflux test show?
This particular reflux test will measure any acidic or non-acidic reflux you get over a set period (24 hours) and how this relates to your symptoms.
Following your test, your data will be analysed, and the results will be written into a report. The report will be sent to both you and your referring consultant/doctor, who will explain the results to you in a follow-up consultation, where they will advise you on the next step in managing your symptoms.
The Oesophagus
The oesophagus is the long muscular tube that helps food travel from the mouth down into the stomach.
At the lower end of the oesophagus and stomach, there is a valve known as the sphincter muscle. This muscle-like valve allows food and drinks to pass into the stomach, closing afterward to stop the stomach’s contents from regurgitating (refluxing) back into the oesophagus.
However, acid reflux can occur when this valve isn’t working as it should or the muscles in this area aren’t contracting, causing symptoms such as heartburn, chest pain, and belching.
In these instances you may be referred for a 24-hour reflux test.
Before the test:
- You can’t eat or drink anything 3 hours before the test
- Make sure to wear comfortable and loose fitting clothing
- Stop taking any over-the-counter antacids
- If you are asthmatic, still use your inhaler as directed and as necessary
- If you are taking heart medication, continue with these unless otherwise directed.
You will be asked to provide any medication you are currently taking and directed as to when to stop taking these. Some medications must be stopped seven days before the 24-hour pH monitoring, others 3 days before, and others 24 hours before. Your consultant will advise and provide full details on all of these during your test booking.
During the Test
The test typically takes around 30 minutes, and you will be asked to return 24 hours later so the equipment can be removed and the results sent for investigation.
During the acid reflux test, you will remain in a seated position and a local anaesthetic (numbing) spray will be used where the tube will be inserted.
A thin medical tube with a probe on the end will then be inserted into the nostril and passed down through the back of your throat until it reaches your stomach.
Note: If you cough or blow your nose, the tube won’t move from its position.
In addition, sipping water through a straw slowly can aid the tube moving through your throat and oesophagus easier.
You may experience an uncomfortable sensation at the back of your throat, but this will settle after a few minutes. You will also be able to breathe normally during the test.
PATIENTS
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CONSULTANTS
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Once the specialist is happy that the tube is in the correct position, it will be secured to your nose and passed around your ear, where it will be attached to a recording box that you will wear as a shoulder strap or as a belt.
The recording device will then measure for 24 hours the pH levels of any fluid that ebbs back into your oesophagus.
When the tube is secured, and the recording box is attached, you can go home and go about your everyday activities, eating and sleeping as usual.
However, during this time you will be advised to:
- Avoid chewing gum
- Do not drink fizzy drinks
- Avoid acidic food
- Avoid citrus fruits
- Not shower or bath
- Do not take any over-the-counter indigestion tablets/medicines.
The following day (24 hours later), you will then be asked to return to have the tube and recording box removed.
Potential Risks or Discomforts
The impedance-pH monitoring test is safe; however, patients might feel some slight discomfort as the tube is inserted into the oesophagus.
You may also feel sick or faint; however, this will pass.
Some patients experience a mild sore throat and a runny nose.
Other potential risks, for all extremely rare, can include:
Bleeding or damage to the inside of the nose, throat, voice box (larynx), oesophagus, or stomach.
Note: If you are sick and the tube moves from the oesophagus to the back of the throat, take a deep breath and gently pull the tube out, carefully placing it in a bag to return to your consultant.
It’s important that you let your consultant know all of the medication you are taking, any allergies you may have, and if you are pregnant.
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After the Test (Post-Procedure Care)
After 24 hours, you can restart any medication and continue your everyday activities as usual.
Your results will be sent to a specialist for investigation, and you will get your detailed results at your next appointment with your consultant, who will discuss the outcome and all treatment solutions.
Interpreting the Results
Your specialist will talk through your results with you and compare the results with your written diary to identify if the number of reflux episodes in the 24 hours is considered `normal,` i.e., less than 40 episodes, or `abnormal` more than 80 episodes are recorded.
The results will also be able to show what type of reflux you are experiencing, i.e., acidic or non-acidic, highlighting if you are suffering from acid reflux or GERD.
Dependant on the results will depend on treatment, which can vary from:
- Diet changes
- Specific medication
- Surgery
Advantages of pH impedance testing
- Provides a clear picture of the volume of acid reflux you are experiencing, helping to rule out reflux or other related conditions
- It helps monitor gastroesophageal reflux disease (GERD) symptoms by measuring the acid and non-acid reflux in the oesophagus
- Improves the accuracy of treatment plans for reflux
Who will benefit from this test?
If you experience heartburn or acid reflux and this doesn’t subside or has been an issue for a long time, this test may be recommended by your GP to investigate the symptoms further and provide you with the right course of treatment.
The acid reflux testing pH is a good test if you have heartburn or suffer from regurgitation that isn’t responding to medication.
It can also be used to check the effectiveness of medications, as well as be part of a preoperative evaluation test before anti-reflux surgery.
Why choose Functional Gut?
All our practitioners have specialist training in all areas of the esophagus and stomach.
We treat a wide range of gastrointestinal and digestive health issues; offering specialist services, we diagnose and provide accurate treatment solutions to a wide range of conditions relating to the oesophagus, stomach, small intestines, gallbladder, colon, liver, and pancreas.
From 24-hour pH impedance to oesophageal manometry tests and electrogastrogram tests, our team works with you to gather patient history details and monitor symptoms to provide the best and most appropriate treatment solutions.
Schedule your appointment today.
PATIENTS
Get an appointment with The Functional Gut and diagnose your gut problem.
CONSULTANTS
Refer your patient to The Functional Gut Clinic for diagnostic tests.
The manner and demeanour of all staff from reception to people carrying out the test was very professional but welcoming and friendly. Atmosphere is very relaxed and all instructions clear and concise.
London Patient
All of the staff were friendly and nice. When I had questions the staff checked on me and made me feel supported. Lovely experience. Everyone had smiles, and they took time to explain and make me feel welcome.
London Patient
Pleasant and knowledgeable staff that made the experience more enjoyable than it should be!
London Patient
The staff were very helpful and patient. Thanks Georgina.
London Patient
FAQ
What is 24-hour pH impedance?
Reflux testing measures how often acid flows back from the stomach to the oesophagus, testing these pH levels over 24 hours. The test is used to clarify if a person is suffering from acid reflux.
How can I book a test?
We have a range of easy booking options, contact a member of our team to find out more: https://thefunctionalgutclinic.com/contact/
What tests do Functional Gut offer for reflux?
Oesophageal manometry tests
Electrogastrogram (EGG) tests
Hydrogen Sulphide Breath Test
Endosign Capsule Sponge Test
PelviPower™
24-hour reflux testing
SIBO – Small intestine bacterial overgrowth tests
Carbohydrate breath test for lactose or fructose intolerance
Gastric emptying tests for gastroparesis
Anorectal manometry tests
Proctogram / defaecography tests
Endoanal ultrasound scan
Pudendal nerve motor latency tests & examinations
Whole-gut transit study
Helicobacter (H) pylori breath test
Laryngopharyngeal reflux (LPR) test
Gastric Alimetryᵀᴹ
Biofeedback therapy
Gastric acid output test
Is there a risk of misdiagnoses?
The 24-hour impedance test is one of the most accurate tests for diagnosing pH levels to identify if a patient suffers from GERD.
As a patient, you can make an appointment with us at The Functional Gut Clinic several different ways. You can:
Ask your consultant to refer you
Ask your doctor to refer you
Contact us directly and we can help
Consultant Referral
A referral to a specialist, health professional, or health service will typically come in the form of a letter from your GP.
Most GP referrals to specialists will last and remain in the system for 12 months.
Referrals are made so you can receive expert and specialist help to gain further diagnosis and treatment of your health problem.
Referrals are made to:
- A specialist doctor
- Health professionals
- X-ray/Radiology departments
- Pathology services
You can receive and request a referral from your doctor, dentist, nurse practitioners, midwives, physiotherapists, and psychologists.
You can also book an appointment with a specialist without a GP referral, however, it is always recommended that you check that this is possible, as every professional and specialist practitioner operates differently.
Medical Doctor Referral
Referrals from your GP last for 12 months and will cover a single course of treatment. If you need longer-term care for ongoing health conditions, your GP can request a referral for longer than the specified 12 months.
In addition, you can also request that your GP referral have no end date.
Note: All new health conditions will require new referrals. If your symptoms change or worsen, please talk to your GP again.
Specialists can refer you to another specialist if they believe it to be beneficial, and these referrals, once placed, are limited to 3 months.
If you would like a second opinion or another point of view, you can also request to be referred to another specialist. This option can help provide peace of mind and offer you information and a better understanding of alternative treatment options.
Don’t have a doctor or consultant? Contact us directly.
If you have reflux symptoms, such as heartburn, and want advice on what to next or how to get tested, contact us directly. The Functional Gut Clinic will provide you with names of recommended consultants. You can then choose the consultant you would like to make an appointment with, and they will refer you for testing.
What is included in a referral?
The medical referral letter includes information relating to your condition, treatment to date, and ongoing symptoms.
Information is transferred to and from your GP and specialist; all medical information is private and confidential.
Information in the GP referral letter will include detailed information and testing insights that have been carried out previously. All up-to-date information about your health problems, the date of the referral, the reason for the referral, and the name and contact details of the person putting forward the referral.
To obtain a referral, you must make an appointment with your GP, talk to them about your health issue, and request a referral to be placed with a specialist for further investigation.
Typically, the referral will be sent as a general specialist referral, however, you are able to choose a particular specialist if you would prefer.
You also have the option for private or NHS referral, and these options will be discussed with you during your GP visit.
Why choose Functional Gut?
Diagnosing your gut problem instantly, our specialist gut clinic helps you to take control of your gut health, providing you with the answers to your health problems.
Our range of diagnostic tests helps us to ensure a quick and accurate process as we focus on patient improvement outcomes.
We ensure we communicate with our patients, providing clear and concise information relating to the testing process, treatment options, and aftercare.
Patient safety is at the heart of everything we do, and we use our specialist knowledge and experience to ensure the best care for all our patients.
To find out more, visit our About Us pages.
Consultant Testimonials
Detailed and helpful interpretation of investigations with suggestion of next best steps.
Responsive when asking for advice or clarification.
For any healthcare provider seeking a reliable and expert partner in gastrointestinal diagnostics, I highly recommend the Functional Gut Clinic in Manchester.
Patient FAQs
How long does it take to get an appointment once a referral is made?
We will contact you within 24-hours of receiving your referral.
How quick are test results received?
Once we have performed your test, results are available within 5 days for most of our tests.
What is your success rate?
We have a very high success rate for invasive testing, so if you have struggled to tolerate a procedure elsewhere, please reach out to us.