Oesophageal Manometry and 24 hour pH and Impedance test

Please speak to a member of staff if you need this leaflet in large print, braille, audio or another language

 

Introduction

Your Specialist has recommended that you have an oesophageal manometry/pH/impedance test to investigate your symptoms.

You will be asked to attend Royal Stoke Hospital Endoscopy Unit.

Your appointment

Expect to be in the unit for up to 1 hour approximately.

Oesophageal manometry/pH/impedance appointments are in high demand so if you are unable to attend your appointment, please contact the Endoscopy Unit as soon as possible Tel: 01782 676010 This will allow your appointment to be offered to another patient.

If you call to cancel your appointment, you will need to provide:

· Your full name.

· Date of birth.

· Date of your test,

· Contact telephone number.

You are advised to discuss with your Doctor the implications of not having this procedure.

 

What is oesophageal manometry?

Oesophageal manometry is a test which measures the pressures in the oesophagus and how the sphincters (ring like muscles which open and close at either end of the oesophagus) are working.

This is done by passing a multi-channel probe which has sensors situated at 1cm intervals via the nose.

 

What is a pH and impedance test?

This test provides information about the amount of reflux that is coming up into the oesophagus from the stomach.

A small tube is passed via the nose which measures the acidic or non- acidic reflux you get over a 24 hour period and how it relates to your symptoms. .

You do not need to be sedated for either of these procedures

 

What are the benefits and risks to oesophageal manometry/pH and impedance monitoring?

The tests help to investigate symptoms and be able to treat them.

The tests do have their risks but major and serious complications are rare.

These tests will be discussed with you and any risks identified before you sign the consent form.

These can include:

· A sore throat.

· A nose bleed or a runny nose, however this is rare.

· Occasionally the tube may enter the larynx (voice box) and cause you to cough. When this happens the tube will be gently pulled back a few centimeters.

 

Preparation instructions

Seven Days before your tests.

Stop taking proton pump inhibitors (PPI) such as:

· Esomeprazole (Nexium).

· Lansoprazole (Zoton).

· Omeprazole (Losec).

 · Pantoprazole (Protium).

 · Rabeprazole (Pariet).

 

Three Days before your tests.

Stop taking:

 · Cimetidine (Tagamet).

 · Famotidine (Pepcid).

· Ranitidine (Zantac).

 · Alverine citrate (Spasmonal).

· Buscopan.

· Baclofen.

· Domperidone (Motilium).

 · Mebeverine (Colofac).

 · Metoclopramide (Maxolon).

 

Two days before your test.

Stop taking opioid medications, including Co-codamol, Tramadol and Codeine. If you can stop, this can affect the test results.

One Day before your tests.

Stop taking:

· Gaviscon.

· Rennies.

 · Settlers

 

Day of the tests.

· Do not have anything to eat (including sweets and chewing gum) 4 hours before the test.

 · Unless you are told otherwise, please stop drinking clear fluids 2 hours before your appointment at the hospital.

 · If you are diabetic, continue with your normal diet.

· Wear loose fitting clothes if possible.

 · Do not apply face cream or wear make-up.

 

What should I bring on the day?

· If you are diabetic please bring your insulin or tablets.

· Your prescription medication.

 · Your reading glasses so that you can read the consent form.

 

When you arrive

Please report to the Endoscopy Reception. You will be greeted by a Physiologist and then: · You will be asked several questions about your health and current medication. · You may be asked to sign a consent form. · Please talk to us about any worries or concerns that you may have.

 

What should I bring on the day?

 · If you are diabetic please bring your insulin or tablets.

· Your prescription medication.

· Your reading glasses so that you can read the consent form.

 

When you arrive

Please report to the Endoscopy Reception. You will be greeted by a Physiologist and then:

 · You will be asked several questions about your health and current medication.

· You may be asked to sign a consent form.

 · Please talk to us about any worries or concerns that you may have.

 

What about my medication?

If you are taking any medication for your heart, breathing problems or hormone therapy, please continue to take them as usual.

· If you are diabetic, please contact the Diabetic Nurse Specialist for advice Tel: 01782 679770 or 01782 715444 and ask if you should change your morning dose.

· Only take oral hypoglycaemic medicines after completion of the test and when you start eating again.

· If you have any other concerns about your medication, please seek advice from your GP.

 

During your test

You will be asked to sit upright on a couch so that a probe (tube) can be passed via your nostril down the back of your throat and into your stomach. You will be given some water to drink to ease the passage of the tube.

· Once in position it will taped to your nose to hold it in place for the duration of the study.

· Each stage of the procedure will be explained to you as it happens.

· Your level of comfort will be monitored.

· The process of placing the tube and undertaking the study is around 20 -30 minutes.

· You will then be asked to lie down with a pillow underneath your head.

· You will be asked to try not to swallow for the first 30 seconds as this allows for a baseline measurement to be taken.

· You will be given 5ml of water to swallow approximately 10 times.

· You will then be given five 2ml water swallows consecutively.

· You will then be asked to sit in the upright position.

· Following this, a further 5ml water swallows will be given to you.

· You may then be asked to swallow solid foods such as bread or rice. If you are gluten-intolerant, you can bring with you your own bread.

· You will be asked to drink 200ml of water through a drinking straw.

· The tube will then be removed.

· The 24-hour tube will then be inserted via the nose, taped into place and connected to a recording device (slightly bigger than a mobile phone).

· The Physiologist will then explain how to use the recorder and give you a diary sheet to fill in

 

Please record when you experience symptoms such as heartburn, regurgitation, belching, coughing etc. You will do this by pressing buttons on the recorder and also documenting this on your diary sheet.

· During the study you will not be able to take your anti reflux, indigestion medication or antacids for the 24 hour period.

· You should not shower or take a bath during the study as this will damage the equipment.

· You will be given instructions to return the following day where the tube and the recording device will be removed.

· You will be in the department no more than15 minutes.

 

After your test

You will be free to leave straight away and resume your daily activities.

· You may restart taking you medication again after your 24 hour test is completed.

 

When will I know the results?

The results will be sent within 5 working days of the completion of your test to your Consultant in charge of your care. A copy will also be sent to your GP.

The Consultant will then decide the most appropriate treatment for you and you will receive a clinic appointment.

If you do not hear anything from the hospital within 6 weeks, please contact your Consultant’s secretary via the hospital switchboard on 01782 715444.

 

Concerns or questions

For further advice please contact the Endoscopy Unit between 8am and 5pm Monday to Thursday:

Endoscopy Unit Tel: 01782 675715

Please leave your contact number, full name, date of birth and date of your procedure as this is a voicemail facility. We will return your call as soon as possible.

Sources of information and support

Bladder and Bowel Foundation Email: info@bladderandbowelfoundation.org

Website: www.bladderand bowelfoundation.org Website : www.bowel-control.co.uk

 

Free Bus Service

There is a free shuttle bus service between Royal Stoke and County sites.

Members of the public who wish to use this service are required to pre-book their journey in advance:

Shuttle Bus booking line Tel: 01782 824232

 

How to find us

County Hospital (formerly Stafford Hospital), Weston Road, Stafford, ST16 3SA. Tel: 01785 257731 Endoscopy Unit is on the ground floor. Royal Stoke Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG. Tel: 01782 715444 Endoscopy Unit is on lower gr