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24 hour ph monitoring/impedence test

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Posted 6/14/2007 4:24 PM (GMT 0)
My GI recommends this to confirm my reflux because I only have throat symptoms and the Nexium 80mg works on me up and down. For anyone who has done it who does it feel when you wear it? Do you have discomfort in your throat and chest during the whole day and when they insert it does it hurt? Let me know.
Posted 6/18/2007 1:41 PM (GMT 0)
Hello Weiner,
This test was recommended for me some yrs ago, and I elected not to do it. But, I really regret not having this test performed, because when I had an Endoscopy approx 3 yrs ago, doc was unable to tell me if I had true Gerd as a result of yrs of PPI's resulting in scar tissue.

I was treated for H-Pylori, and doc indicated if my reflux symptoms returned after treatment, assume I have GERD and continue PPI's. I have no doubt that GERD is a culprit for me, but it would have been nice to have gotten a more scientific confirmation.

Good Luck with your test, and let us know of the findings.

Huggs,
VV
Posted 6/22/2007 2:11 AM (GMT 0)

I was waiting to see if someone else would respond who had the ph monitoring test.  Before I go into this, bear in mind that I always gag every time I brush my teeth.  My first attempt at having the test was a failure.  The nurses and I tried three times and I ended up trying to fight them.  Remember I have a terrible gag reflex.  The reason I was having the test done in the first place was because we suspected that my GERD was triggering some of my asthma attacks.  The pulmonologist I saw wanted me to try to repeat the ph monitoring and I just decided to find a new pulmnologist.  I was glad I did.  Actually my allergist referred me to this one.  He went to bat for me and got them to insert the tube under general anesthesia and it was a breeze.  The doctor told me that the hospital kept calling him to say that they didn't do this procedure under general anesthesia and he insisted that I had to have it that way.  Once it was in, I had no problem at all wearing it for the 24 hours.  I do not want to scare you at all.  Again, I have a terrible gag reflex.  I'm a terrible dental patient.  I really did need to have that test performed and it sounds like maybe you do also.  The wire is tiny and is covered in plastic.  It goes up your nose, down your throat and into your esophagus.  I did end up having the lap Nissen done.  It did help a little with my asthma.  I do still have to take Nexium.  I wonder if you could go by the hospital and ask to look at the wire?  That might ease your mind.  If you don't have a gag reflex problem, once it's in, I really have to say it's not as bad as you might think.  You definitely know there's something in your throat, but you can tolerate it.  If I can answer any other questions, please do not hesitate to ask.

Good luck!

Carla

Posted 6/23/2007 7:05 AM (GMT 0)
Hello, I've had the esophageal manometry (the swallowing test) in the office and the 24 hour pH test as well.
They were both fairly unpleasant, to be honest, but nothing worse than unpleasant, nothing painful. Just uncomfortable when they stick the tube through your nose and down into your stomach. If you can relax, it's not so bad and is over fairly quickly (the manometry). Relaxation is the key, because if you get anxious and worked up you'll probably gag more and it will make the test last longer. The 24 hour pH test is a little more difficult as it feels like you have a wad of hair in your throat that you can't cough up, but the tube is significantly smaller than the one they use for the swallow test. You have to record every time you lay down or eat so that the machine can calculate acid reflux/dysphagia, etc. I just tried to occupy myself so that I wasn't thinking about it. Like I said it wasn't painful for 24 hours, just strange and kind of annoying, like having an itch you can't scratch. Any other questions let me know! Hope this helps.
-Emma
Posted 6/24/2007 2:44 PM (GMT 0)
The worst aspect of these tests would have to be going off the PPIs for three days before the tests are undertaken. This, at least, is what I have to do in the coming weeks.
Posted 6/25/2007 2:23 AM (GMT 0)
emma24, did you learn anything from the manometry test?  Because I don't have a copy of the test from the GI doc.  I have terrible reflux and burping and a whole slew of digestion problems.  Yet, I found that the PH-monitoring and manometry did nothing to help me.

Posted 6/25/2007 7:06 AM (GMT 0)
Hi friendlygal. The only thing I learned from the manometry was that my swallowing is normal and strong. I think those two tests are just to see if your case is serious enough for surgery (LES) or not? And to see if your problems lie in the functioning or malfunctioning of your swallowing? As for the 24 hour pH test, nothing was gained, absolutely nothing, as I was told to continue taking prescription meds as usual, which included Nexium. I was confused about this as I didn't see a point in taking my acidity test on Nexium (as it reduces so much of the acid and reflux!) but was pretty naive and trusting at the time;
I should have been more assertive, but when the results came back, ( I never got a copy either), they said that I was "borderline" serious. Whatever that means. I wonder what the test would have been like had I stopped taking the PPI 3 or 4 days before.....What a waste of money. So, sorry, I'm pretty disillusioned by the whole doctor thing. I don't really trust any of the doctors that I've had thus far. Looks like you've had a similar experience?
-Emma
Posted 6/26/2007 5:42 PM (GMT 0)

emma24, you were on PPIs still when taking the test?  I was off of them for like a week, then I took the test.  Some people stay on them so that the doctors can see if the PPIs are working.  But usually people are off of them before the test...

Yes, I have found the doctors to be useless...

Someone yesterday told me that it is possible that I have H.Pylori but that the PCP's blood test wasn't effective enough.  She gave me two other leads. 

All I know is that I have been suffering for about a year!!  I have not taken prevacid this week because I am too confused about everything.  I almost feel that I shouldn't be on the PPIs anymore!!  I am wondering if I should go to a different kind of doctor, not a GI and not an ENT!

Posted 6/26/2007 6:56 PM (GMT 0)
Hi Friendlygal,

Yeah, I'm getting fed up with the whole thing too. For the past week or so I've been trying to quit Nexium: two days without, then one day of nexium, then two days without, etc. I have no idea if this is safe or not, but at this point, I'm just so ready to be off Nexium and to find another cure that will rid me of this problem for good! My gastroenterologist is in another city and I'm looking around for another good one...but if he/she tries to get me back on PPIs I'm considering a homeopathic doctor....who knows. It's been almost 3 years on PPIs for me, and I just don't think that's a good thing at all. Grrr!
Posted 6/26/2007 8:02 PM (GMT 0)

emma24, i hear ya!!  i was ALSO thinkin of going to a naturopath/homeopathic doctor myself!!

someone yesterday, whom I met at CVS, told me of this medical Doctor who people go to in DC when they can't find out what is wrong with them.  He will do all the research necessary to help.  So I am going to meet with him!!  I HOPE that this will help!  It sounds like a great lead!!

He's not a homeopathic doctor...

Posted 6/28/2007 7:08 AM (GMT 0)

emma24 said...
Hi Friendlygal,

Yeah, I'm getting fed up with the whole thing too. For the past week or so I've been trying to quit Nexium: two days without, then one day of nexium, then two days without, etc. I have no idea if this is safe or not, but at this point, I'm just so ready to be off Nexium and to find another cure that will rid me of this problem for good! My gastroenterologist is in another city and I'm looking around for another good one...but if he/she tries to get me back on PPIs I'm considering a homeopathic doctor....who knows. It's been almost 3 years on PPIs for me, and I just don't think that's a good thing at all. Grrr!

Dear Emma, I have given gerd so much thought, but I believe I am now in a position to offer very useful advice. Firstly, some people suffer from gerd because they produce too much acid. For these individuals, PPIs might be very useful and even more so if the GIs find ulcers. Other people have damaged sphincter muscles and the only real solution at present is surgery. The surgery is much more likely to be successful if the patient does not have a large hiatal hernia. Forget diet (although small meals help while you are waiting for surgery) and anxiety drugs. Gerd is real, not a creation of the imagination or an excuse for doctors who simply don't have the answers!

I also have a theory about LPR. I believe this is still a bi product of Gerd plus PPIs - again especially for the type 2 patient who have damaged sphincters rather than too much acid production. I hope this helps someone.
Posted 6/28/2007 5:01 PM (GMT 0)

christo, I agree with a lot of what you say...But I had LPR before the PPIs too.  so I don't think that PPIs cause it...

As for the surgery, don't you need to have a large hiatal hernia to get it?

Posted 6/28/2007 11:09 PM (GMT 0)
My specialist said large hiatal hernias was the main reason for failure. You get the surgery because the LES has failed. If you have a hernia, you might need to get that fixed as well. The source of the problem is in the lower esophagael sphincter (LES).

On LPR, you might be right, but I still regard it as a derivative of LES problems. If your reflux is not particularly acidic (i.e. chest pains rather than heartburn), the PPIs might actually worsen LPR. I don't believe LPR is at root an upper sphincter problem, although constant exposure to acid will damage the anatomy in that region.

Hope everyone is well. I should have bigger news with my own situation soon. I would advise everyone who takes PPIs to get evaluated for surgery at the very least.

Post Edited (Christo) : 6/29/2007 1:55:57 PM (GMT-6)

Posted 6/28/2007 11:11 PM (GMT 0)
Christo, doctors don't want to give surgery.  That's what I've seen...It is only the very, very last resort...they would much rather give PPIs...

Posted 6/29/2007 4:59 AM (GMT 0)
If the PPIs work, that is the case. However, PPIs do not stop you from experiencing reflux, they only change what you reflux.

However, what is the harm in getting the LES evaluated? If it's mechanical (i.e. to do with the LES) rather than due to the excessive production of acid, why not go for surgery?

19 out of 20 people are happy they had the surgery 5 years on. (see also the heart-burn Help website).

Anyway, this is what I'll be doing if I can :)

I should have more info in the next week as I am getting manometry and 24 hour ph testing performed next Tuesday.

Post Edited (Christo) : 6/29/2007 1:54:52 PM (GMT-6)

Posted 6/29/2007 5:51 AM (GMT 0)

From my experience, physicians are more apt to want to repair the esophagus if you also have a hiatal hernia, which I did.

Carla

Posted 6/29/2007 6:48 PM (GMT 0)

Christo, I've already had a manometry and ph-testing.  AND the ppis don't help at all...Because I burp nonstop from my reflux mess, the doc says that I would be miserable with the surgery (it makes it impossible to burp)...He won't give it to me...

about having a hiatal hernia, I'm confused because a GI who is known as a fantastic doctor did my endoscopy.  He says that I don't have a hiatal hernia, yet another one said (by looking at the pictures of his results) that I do have a "mild" hiatal hernia.

I also met a girl whom her doctors told didn't have a hiatal hernia.  Upon going for her gall bladder surgery, they found a huge one.  They wouldn't have seen that if she hadn't been cut open..

Posted 6/29/2007 7:08 PM (GMT 0)
There are two issues. I'm not saying that people with large hiatal hernias shouldn't have surgery (and by surgery I'm talking about fundoplication); rather I am saying that the large hernias are the main factors limiting the success of surgery. A mild hiatal hernia would not lessen the success chances of fundoplication.

I don't know why your doctor said fundoplication would not help you. It may have something to do with the manometry results (did he ask for the test?). Alternatively, he might have something against the procedure. A lot of doctors do, but then again they don't suffer from gerd. For goodness sake, get an opinion from a specialist who performs fundoplication. You might be suffering unnecessarily.

I really wish you well. I don't burp constantly so my situation is different to yours. However, it is true that you might not be able to burp with fundoplication. I am not a doctor - just an educated layman suffering like you. I have done a huge amount of research and I am very confident that fundoplication is still the best way to go.

I could recommend three sites (two of them are forums) that have heaps of info on surgery. However, I'm not sure I'm allowed to post them.

You deserve better. The PPIs aren't working. Please get another opinion. I would also try and obtain your results of the ph testing.

Post Edited (Christo) : 6/29/2007 1:57:28 PM (GMT-6)

Posted 6/29/2007 7:14 PM (GMT 0)

Thanks, Christo...I have gone to sooo many specialists...I really don't know what to do at this point.  The burping incessantly is terrible...And the PPis don't work..

I certainly have discussed surgery with doctors, time and time again....

Posted 6/30/2007 4:34 AM (GMT 0)

Just to clear up a few things, after I had my Nissen's fundiflication, I was eventually able to burp again.  It did take a while before I was able to throw up again.  But, who wants to do that any  way.  I did have times when my esophagus was still very tight and I couldn't seem to get food down that I would try to get it to come back up, but it wouldn't. I only tried to throw it back up because I was in such pain when something was caught in the esophagus.  I was just stuck with it until it finally worked its way on down.  I also had a hiatal hernia.  I basically had this surgery done because it was triggering some of my asthma attacks.  It didn't take long before I tore my hernia repair and now have a sliding hiatal hernia.  I hope this little bit of information is helpful.  You will be able to burp again, it just takes a while.

Posted 6/30/2007 2:54 PM (GMT 0)

anotherday, thanks for your post...I want to make something clear: I don't like burping!  Since I've had my digestion issues, one of my main symptoms is constant, nonstop burping.  I hate it.  I am FORCED to do it.  So the GI doc says that, with the surgery, it would make me miserable.  How long couldn't you burp?

And...overrall, did you find the surgery helpful?

Posted 7/1/2007 3:20 AM (GMT 0)
friendlygal, It's been a couple of years since I had my surgery, but I think it took a month or two before I was able to burp, maybe not that long.  It was a relief when I could burp again, until that time, the gas was trapped in the esophagus, if I had eaten or drank the wrong things.

The main reason I had the Nissen's fundoflication and hernia repair was because of my severe asthma.  My doctors thought this was one of my triggers.  It did help my asthma a little and helped my GERD a lot.  I do still have to take Nexium, but from what I hear this is not unusual. 

Carla

This thread is cllosed - Please do not post to this thread from 3 years ago.

Post Edited By Moderator (stkitt) : 7/22/2010 7:57:31 AM (GMT-6)

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