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PH monitoring and Manometry test

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GERD & Acid Reflux
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Posted 7/5/2015 3:03 PM (GMT 0)
I have been told I am a good candidate for surgery but I have to have a PH monitoring and manometry test before I can have it. Can anyone tell me what is involve with these?
Posted 7/5/2015 6:15 PM (GMT 0)
They place a tiny tube through your nose and all the way down to your stomach. Mine I had it in for 2 days with a little computer attached with a over the shoulder strap.

I had zero pain. The only thing was a slightly scratch throat (which was no worse than a very slight cold). And you also have the sensation of needing to swallow like you have something tiny in the back of your throat. Which after a few hours is just annoying but not troublesome at all.

The information can be vital, but as I said on another post. The procedure is a million times worse to think about before hand than it is to go through.

Wishing you all the best!!
Posted 7/5/2015 8:44 PM (GMT 0)
I agree the thought of it is worse than the actual test. I've had 3 performed. You have the manometry performed at the hospital, they put a thin tube up your nose and down into your stomach to take measurements such as the height of your LES And upper sphincter. . It takes the pressure measurement of each of those valves. You are asked to swallow little drops of water and each time the tube will neasure the strength of your swallow as it moves the water to your stomach. This highlights any motility disorder and will also be a good indicator of your suitability for surgery. It lasts about 25/30 mins but I find it goes quicker if you take your mind to a happy place and just chill out as much as you can. It honestly isn't bad. I agree with CMarshall in that after a couple of hours of having the probe in your throat gets used to it being there and is just a mild irritant. A tip for you that when you swallow push into the nostril that has the tube in, the physiologist who performed the test adviaed me to do this and it really helps. Whatever you do, don't avoid food and I was told to eat my trigger foods so that it would show up. Good luck, you'll be fine!
Posted 7/6/2015 7:54 AM (GMT 0)
I read on here that someone had the manometry tests and they threw up everywhere. I am terrified of vomiting and that is what is scaring me. As well as the thought of coming off my meds. How long do you have to be off them for before the tests? I have been taking them for nearly 10 years so know I am going to suffer when I don't take them.

I saw a private doctor for the endoscopy and colonoscopy which I paid for myself. He said I am a good candidate for surgery but I can't afford to pay for that privately as well. I am going to see my GP today to see if I can get it done on the NHS but obviously need to find a good surgeon that will be willing to do it.

I know it will probably make me better in the long run but I am so scared about it
Posted 7/6/2015 4:19 PM (GMT 0)
Jennie

To be honest, the test wishes to see you in bouts. It takes (I assume) readings in times of bouts. They wish you to eat foods that do trigger reactions. But in what we all live with and have lived with, 24 hour is all you need to get through. The test part (tube, slight irritation, etc.) is nothing. It is more so our conditions which cause the vomiting.

I wish I could remember exactly how long you need to stop your medication. I hope that someone can maybe comment on that.

Jennie, my point is the anxiety of our condition is absolutely present, but the test does not need to add much to that anxiety. I wish you all the best and have faith you can get through it.
Posted 7/7/2015 12:59 AM (GMT 0)
@jennie what surgery are you having?
Posted 7/7/2015 8:17 AM (GMT 0)
I'm not having anything yet. My private doctor wants me to have the wrap but when I went to see my GP last night to get it done on the NHS, he was very reluctant to do it. Think I am going to have to save the money and get it done. I can't go on like this
Posted 7/7/2015 3:47 PM (GMT 0)
Hi jennie please don't worry too much about vomiting, I vonited but think it was because my test was brought forward and I had food too close to the test. I've had a further 2 manometry and ph test and was absolutely fine. Just make sure you follow guidelines for meals before hand. With regards to surgery, ive had a nissen performed on nhs and when I knew I was still having symptoms the surgeon refused to believe I was still suffering. I paid to see another consultant privately, paid to have bravo test and was offereded impedance on nhs. All my consultations have been private. I was told I needed further surgery and it was assumed I would pay for surgery privately I spoke to the consultant and said I coukd no way afford 10k and he was fine with me being put back onto his nhs list. If your results indicate a need for surgery then you shouldn't have problems having it performed via the NHS even if all tests and consultations have been private.
Posted 7/7/2015 5:48 PM (GMT 0)
Thanks. That's what I'm hoping. I'm just worrying now that the tests will show that I can't have the surgery. I need to be free from this reflux and this is my last hope. For what reasons would they say I can't have it? My GI doc said they are to see how many of my symptoms are caused my reflux. What else could it be if I have all the symptoms and a small hernia?
Posted 7/7/2015 7:31 PM (GMT 0)
Jennie,
If your GP is unhelpful, get a second opinion! I saw one doctor at my practice, who just wanted to throw lots of tablets at me. I saw another doctor at the same practice, who put me forward to hospital to get endoscopy. I found I had a small hiatus hernia, which was giving me hell. The GI doctor I saw was horrible, he was anti-surgery, but I said I would get a second opinion, amazingly he got me an appointment with a surgeon, to have a chat about pro's and con's of an op. In the mean time I had manometry and ph test. Within 5 minutes of chatting to the surgeon, I was on his waiting list!
I am now 4 months post op. It took a long time , about 18 months start to finish on NHS, but well worth it in my case. Don't give up! You have to keep pestering and you will get there!
Posted 7/7/2015 7:34 PM (GMT 0)
Hi Jennie I had this test in January and was dreading it - the thought was worse that the actual test - I also have a fear of vomiting but the Dr who administered the test told me to breathe slowly - if you breathe you won't retch and once the tube is in you get used to it. I found hot tea helped soothe my throat and could eat fully throughout the 24 hours it was in. Glad I had it - it showed I had a very high Demeester score (the acid reflux score) and have now just had a NF op - one week ago!
Posted 7/7/2015 7:39 PM (GMT 0)
Should have added, with ph and manometry they get you to drink water through a straw to take the catheter into your nose. It's over quicker than you realise, and its no way as bad as an endoscopy!
Posted 7/7/2015 7:45 PM (GMT 0)
I agree with sweetie, if you aren't happy, get a second opinion. We know our bodies the best. Ph studies are a snap
Shot in time and I was told to eat all the trigger foods that would set me off and give me symptoms. I have atypical reflux in that most of my symptoms are airway, ear nose throat and cough symptoms. So I ate the foods guaranteed to trigger them off. Wish you luck
Posted 7/7/2015 7:57 PM (GMT 0)
I did get a second opinion. I went straight to a GI doc and paid £2250 for an endoscopy and colonoscopy. He finally found the small hernia which I've had for years. I think I will be having the bravo ph test which is a capsule isn't it? That's good to know that I can 'control' the gag reflux in a way with slow breaths. That's what got my through my endoscopy (which was my third one). Im dreading being off the pips as well. I might wait till after my holiday in September. I'm going to have the two tests privately and then if I'm a candidate for surgery then I will get it on the NHS. I'm now just worrying that my tests will show that I can't have surgery. In what instance would they say you can't?
Posted 7/7/2015 8:31 PM (GMT 0)
My deemester was only slightly abnormal but my LES IS/was very loose plus the fact that my symptoms weren't controlled by ppi those were the reasons they offered me surgery. Do you have "classic" GERD... Heartburn and indigestion?
My understanding is that if your symptoms are being controlled by ppi, you have a "normal" deemester score, "normal" pressure of the LES, "normal" amount of reflux during the day they don't refer you for surgery. Like I said earlier it's frustrating because ph studies are just 24 hours out of your life and if on that day your symptoms aren't as bad as normal you've had it! Hence why it's important to try and do everything to provoke your symptoms and I was actually told to eat all my trigger foods. Also if you have a motility disorder then in some instances you may be offered partial wrap or it may show that your esophagus isn't strong enough to push food through the wrap and therefore surgery may not be an option.
Posted 7/7/2015 8:41 PM (GMT 0)
I had a barium test shows up volume reflux which you have very well. Good conclusive test .swallow liquid to see if you are refluxing it back up .mine was even standing up !as you have bad volume reflux this is the test I would ask for barium meal test .good luck
Posted 7/7/2015 9:02 PM (GMT 0)
I had the barium swallow test in 2009 which showed reflux (I think it even said significant reflux) and that's when I was diagnosed with GORD. My symptoms are in no way controlled by ppis!! I'm on 40mg of nexium twice a day and go through two large bottles of gaviscon a week!

Trotters - that was really helpful, thank you. Really helped me understand what they will actually be looking for! I have ibs as well and believe that is related to motility and I used to find relief from donperidone before they took it off the market
Posted 7/7/2015 10:12 PM (GMT 0)
I think given the tests have already shown you have reflux they can't really deny it can they.

Sorry to hear you suffer with ibs too... That's a bummer. I had it on and off when I was on ppi funnily enough and also when I was having problems with undiagnosed endonetriosis. Now I'm off ppi and sorted in the pelvic dept its virtually cleared. Only mentioning because sometimes these things can all be closely linked. There is a possibility the ppi could be aggravating your ibs too. Hope you get some answers and some relief soon!
Posted 4/12/2019 6:41 PM (GMT 0)
Trotters, do you remember if you had esophagitis from your endoscopy? If so, was it visually determined or determined from the biopsies?
I ask this because I am waiting to see what my Demeester score is going to be... worried it may not be high enough to be considered for surgery. I have a HH that really needs fixed. The surgeon that did the endo said he couldn’t visually see inflammation of the esophagus. I will know in a few weeks weather or not the biopsies will show inflammation.
My symptoms are very indicative of this HH being the source of my problems.
Thanks for the information!
Posted 4/12/2019 7:03 PM (GMT 0)
Supbluc this is a four year old post so not sure anyone else will get the notification you have sent a message.

I had the bravo test but didn’t need the manometry test as the bravo showed that my symptoms are actually controlled by ppi so I was turned down for surgery
Posted 4/12/2019 9:55 PM (GMT 0)
Hi
No I’ve never been diagnosed with inflammation in my eosphagus. I have gastritis in my stomach. I had biopsies taken from my stomach but this was to check for h pylori. I thought they only took biopsies in your eosphagus if there looks to be anything sinister? I could be wrong. Hope you get sorted soon.
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