Oesophageal manometry and 24-hour pH or impedance monitoring (Southmead) | Bristol NHS Foundation Trust

Oesophageal manometry and 24-hour pH or impedance monitoring (Southmead)

This page provides you with information about your oesophageal (gullet) tests and gives you information about what is involved. You may be having one or both tests and your appointment letter should state this. Once you have been called into the procedure room the test will take approximately 1 hour.

What is the oesophagus? 

The oesophagus is a long muscular tube- like structure which connects your mouth to your stomach. Its function is to pass food and liquid from your mouth to your stomach via muscular contractions. Within your oesophagus you have a valve which helps control the movement of food and liquid down into the stomach and prevent acid from refluxing back up.

How to prepare for the test 

  • Please do not eat or drink for 6 hours before the test. Small amounts of water are safe up to 2 hours before the test.
  • If you have asthma please use your inhalers as directed by your GP and bring them with you on the day of the test. Check the below medication list and stop accordingly – if you are unsure about which medications you need to stop please feel free to contact us.
  • Please wear loose fitting clothes as you will be lying down and they can constrict and interfere with the test.
  • If you are having a 24 pH or impedance test please see below how to prepare for these tests (your appointment letter will state the tests you are having).

Please stop these medications 7 days before your test:

  • Losec (Omperazole)
  • Protium (Pantoprazole)
  • Zoton (Lansoprazole)
  • Pariet (Rabeprazole
  • Nexium (Esomeprazole)
  • Axid (Nizatidine)

Please stop taking these medications 3 days before your test:

  • Zantac (Ranitidine)
  • Maxalon (Metaclopramide)
  • Tagamet (Cimetidine)
  • Motilium (Domperidone)
  • Cisapride (Prepulsid)
  • Motilium (Domperidone)

Please stop taking these medications 24 hours before your test:

  • Gaviscon
  • Rennies
  • Bisodol
  • Tums
  • Asilon
  • Algicon
  • Spasmonal
  • Topal
  • Maalox
  • Nifedipine
  • Mucogel
  • Buscopan

Oesophageal manometry 

This part of the test assesses whether your food pipe is working properly. It also looks at the strength of your valve and whether it open and closes correctly.

How is the test carried out?

A thin flexible tube is passed gently into your nostril. You will then be asked to take small sips of water through a straw which will help move the tube down the oesophagus and into your stomach. You will feel a slight sensation at the back of your throat but it should not be painful.

Once the tube is in place you will be asked to lie down on the couch, propped up slightly by a pillow.

We will then ask you to lie still whilst we take measurement of your oesophagus. Following this you will also be asked to swallow small mouthfuls of water and sometimes food. After this, the test is complete and the tube will be carefully removed.

If you do not need a 24hr pH/impedance monitoring study, you can go about your normal daily activities and resume any medication stopped.

If you may need assistance transferring onto our procedure couch please contact the department before attending your appointment.

24-hour pH or impedance testing 

These tests allow us to look at how much acid or other stomach contents are coming up into your oesophagus from your stomach. 

We like to monitor you for 24-hours so we can record what is happening at both meal times and sleeping periods. 

This test also allows us to monitor your symptoms and see how well they are associated with the presence of acid or stomach contents in your oesophagus.

How is the test carried out?

A thin tube will be passed into your nostril and then down your oesophagus into your stomach with the help of you sipping and swallowing on water.

The tube will be positioned in the oesophagus just above the valve and taped securely to the side of your nose and face. It is importance that this tape stays on to ensure the tube is in the correct place.

You will be asked to record your symptoms, meal times, and bedtime on the monitor throughout the 24 hours. You will also be provided with a paper diary, which should be completed and returned the following day. Symptom recording will be explained to you after your procedure.

You can eat and drink as normal and we encourage you to carry out regular daily activities as well as symptom provoking tasks.

How is the tube removed?

You will be required to take out the tube at home. This will be explained to you during your appointment. Once removed, the white tube and connector can be disposed of as waste.

Please return the monitor and diary sheet to Gate 36 Reception.

Please do not take the specified medication on page 2 until the tube is removed. Once the tube is taken out you can re- continue any medication stopped. 

  • If you have any problems while you have the tube in overnight, please contact the person who performed your test using the on number provided to you.
  • In an emergency situation if you are feeling very unwell please go to A&E.

What are the risks and benefits associated with the test?

The benefit of having the test is to accurately measure how the muscles of your oesophagus and the valve where it joins to your stomach are working. 

There is a small risk of bleeding (in the nose) when the catheter is inserted. There is also a theoretical risk of perforation (a tear) to the oesophagus, but this has never been documented to have happened during one of these tests.

Are there any alternatives to this test?

You should already have had either an upper gastrointestinal (GI) endoscopy or a barium swallow to look at the lining of your oesophagus to check for obstructions. If you have not had one of these tests in the last 2 years, please contact the department before coming to your appointment. This test, however, investigates the muscle function of your oesophagus and currently there is no alternative. 

If you feel like your symptoms have improved since your referral to us or if you require any additional information about the investigations, please contact us using the details on the back page. If unavailable, please leave a message and you will be contacted.

Further appointments

If you require any additional information concerning the investigations or any advice, please contact us using the details below:

  • If no answer, please leave a message and you will be contacted.

Contact GI Physiology

Gate 36, Level 1,
Brunel building, 
Southmead Hospital,
Bristol
BS10 5NB

Phone: 0117 414 8801
Email: bft.giphysiology.southmead@nhs.net