24-Hour Oesophageal pH Monitoring
Objective Assessment of Acid Reflux

At M R Hospitals, Thanjavur, 24-hour oesophageal pH monitoring is available as part of our Advanced Gastrointestinal Physiology services at the Exclusive Alimentary Tract Lab.
Unlike routine endoscopy, which examines the appearance of the oesophagus, 24-hour pH monitoring measures acid exposure in the oesophagus over an extended period during normal daily activities.
It provides objective information that can help determine whether a patient's symptoms are related to gastroesophageal reflux. 

What Is 24-Hour pH Monitoring?

24-hour oesophageal pH monitoring is a specialised investigation that continuously records the amount and duration of acid exposure in the oesophagus.

A thin sensor catheter is positioned in the oesophagus and connected to a small recording device. The patient can generally continue normal daily activities while the study records reflux episodes.

The recorded information is subsequently analysed by the specialist to assess the pattern and severity of acid reflux. 

When Is the Test Recommended?

Your doctor may recommend 24-hour pH monitoring for:
• Persistent heartburn
• Acid regurgitation
• Reflux symptoms despite medication
• Symptoms with a normal upper GI endoscopy
• Unexplained chest discomfort
• Suspected reflux-related cough or throat symptoms
• Evaluation of persistent symptoms before selected anti-reflux procedures
• Assessment of patients with suspected gastroesophageal reflux disease 

Why Is pH Monitoring Important?

Symptoms alone do not always establish whether reflux is responsible for a patient's complaints.
Some patients may have significant reflux despite a normal endoscopy, while others may continue to experience symptoms even when there is no significant acid exposure.
24-hour pH monitoring provides objective physiological data that can help the treating team make a more accurate diagnosis.
Endoscopy vs pH Monitoring
Upper GI Endoscopy
Examines the oesophagus, stomach and duodenum for structural abnormalities and mucosal disease.
24-Hour pH Monitoring
Measures acid exposure and reflux over an extended period.
The two investigations therefore provide complementary information.

pH Monitoring Before Anti-Reflux Surgery

For appropriately selected patients being considered for anti-reflux surgery or other advanced reflux interventions, objective reflux assessment may be an important part of the preoperative evaluation.
pH monitoring can help establish whether abnormal acid exposure is present and provide information that assists in treatment planning.

Combined Oesophageal Physiology Assessment

When required, 24-hour pH monitoring can be performed along with oesophageal manometry.
Oesophageal Manometry
Assesses:
• Oesophageal contractions
• Swallowing coordination
• Upper and lower oesophageal sphincter function
• Oesophageal motility disorders

24-Hour pH Monitoring

Assesses:
• Acid exposure
• Frequency of reflux episodes
• Duration of acid exposure
• Relationship between reflux episodes and symptoms
Together, these investigations provide a more comprehensive assessment of oesophageal function and reflux disease.

Constipation & Pelvic Floor Disorders

Not all constipation is caused by slow movement of stool through the intestine.
Some patients have a defecatory disorder, where the pelvic floor and anal sphincter muscles do not coordinate properly during attempted bowel evacuation.
Anorectal manometry can help identify these functional problems and guide further management.
Depending on the findings, treatment may include dietary modification, medications, pelvic floor physiotherapy or biofeedback therapy, rather than simply escalating laxative treatment. 

A Minimally Invasive Approach in Selected Children

What Does the Study Tell Us?

The study can provide information about:

• Total oesophageal acid exposure
• Frequency of reflux episodes
• Duration of reflux episodes
• Reflux occurring during different periods of the day
• Relationship between symptoms and reflux episodes

This information helps the treating specialist determine whether abnormal acid reflux is likely to be contributing to the patient's symptoms. 

About consultant

How Is the Procedure Performed?

How Is the Study Performed?

The process typically involves:

1. Preparation

  • The patient receives instructions regarding fasting and medications before the study. Certain acid-suppressing medications may need to be modified depending on the clinical question.

2. Sensor Placement

  • A thin catheter with a pH sensor is gently passed through the nose and positioned in the oesophagus.

3. 24-Hour Recording

  • The catheter is connected to a small portable recording device. The patient can generally continue normal daily activities while the study records acid exposure.
  • Patients may also be asked to record:
  • • Meals
  • • Lying down or sleeping periods
  • • Symptoms
  • • Medication intake

4. Analysis

  • After completion of the recording period, the data are analysed to determine the patient's reflux pattern and its relationship to reported symptoms.

Advanced Gastrointestinal Physiology at M R Hospitals

24-hour pH monitoring is part of the Exclusive Alimentary Tract Lab at M R Hospitals, which also provides:

• Oesophageal manometry
• Anorectal manometry
• Upper GI endoscopy
• Colonoscopy
• ERCP
• Paediatric endoscopy
• Bronchoscopy

This allows comprehensive assessment of both the structure and function of the gastrointestinal tract.
 


From Symptoms to Targeted Treatment

For patients with persistent or unexplained reflux symptoms:
Clinical Assessment → Endoscopy → Oesophageal Physiology Testing → Objective Diagnosis → Individualised Treatment
Our Gastroenterology and Surgical Gastroenterology teams can use the results to guide appropriate medical, endoscopic or surgical treatment.
M R Hospitals, Thanjavur
24-Hour Oesophageal pH Monitoring | Advanced Gastrointestinal Physiology | Objective Assessment of Acid Reflux

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