Catheter Reflux Testing
A physiological test to assess acidic and non-acidic reflux events a patient may experience over a period of 24 hours.
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Catheter Reflux Testing
This is a test, commonly referred to as 24-hour pH/impedance monitoring, performed to determine how frequently solid, fluid and gas from the stomach refluxes into the oesophagus. This can be useful for determining abnormal acid reflux and its association with a patient’s symptoms. However, it has now become recognised that some patients’ symptoms are caused by reflux from the stomach which is non-acidic. This can be missed by traditional pH testing and, consequently, patients are told that their symptoms are not reflux-related when in fact they are. We, therefore, combine the pH test with impedance monitoring. Where the traditional method is limited to measuring only the presence or absence of acid, the combined test can also monitor episodes of non-acid reflux.
In this short video Mr Nick Boyle, Medical Director at RefluxUK, talks about physiology tests and how we use them to inform your treatment.
How is it performed?
A small catheter containing a specially constructed probe is passed through the nostril to the back of the oesophagus. The probe detects the changes in electrical resistance and also measures the pH levels around the oesophagus. These measurements are relayed via the catheter to a portable recorder which is worn for the duration of the test. When symptoms are experienced they can be recorded by the patient by pushing a button. After the 24-hour test is complete the probe is removed and the data is collected for interpretation. Although the procedure can feel initially uncomfortable, it is not usually painful and local anaesthetic can be used to aid in the insertion of the catheter.
What will the tests show?
By measuring impedance combined with traditional pH measures, any movement of gas or liquid is recognised, regardless of acidity, allowing a more thorough evaluation. As well as reflux and reflux symptoms, swallowing behaviours such as aerophagia can be studied and their association with reflux recorded by the probe. Impedance-pH monitoring is also able to evaluate the extent of reflux along the length of the oesophagus or beyond the larynx (voice box). This is especially useful for evaluating reflux symptoms affecting the throat, including globus (a lump in the throat feeling), hoarseness and chronic cough. These symptoms are common, especially in laryngo-pharyngeal reflux (LPR), which can be related to reflux of all kinds.