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24-hour Reflux pH Monitoring

For definitive diagnosis of gastro-oesophageal reflux disease (GORD)

What is 24-hour reflux pH monitoring?

pH monitoring involves passage of a thin tube (pH catheter) through the nose and into the oesophagus. This thin tube measures pH (acidity) in the oesophagus. By doing so, your doctor can determine how often you are having acid reflux and how severe it is. 


Why might I need pH monitoring?

The most common reason for having the test done is when you are having symptoms that are suggestive of GORD (acid reflux). These include heartburn, regurgitation and chest pain. Sometimes, the test might be performed due to throat symptoms that are suspected to be secondary to acid reflux (e.g. cough, hoarse voice or excessive throat clearing).

For patients with such symptoms, the initial test is usually endoscopy. However, in most patients with reflux, the endoscopy is normal. In such situations, 24-hour pH monitoring may be required to obtain a definitive diagnosis of GORD and to determine if your symptoms are really due to acid reflux events.


What happens during the pH monitoring study?

While sitting comfortably, you will receive a local anaesthetic spray in the nose. Then, a thin tube (manometry catheter) will be passed through your nose, into your oesophagus and down to your stomach. Once secured in the correct position, you will be shown how to log your symptoms, mealtimes and sleep timings on the recorder that you will carry around with you for the day. This allows your doctor to determine if your symptoms occur at the times of an acid reflux event. You will then be allowed to leave and you may go about your usual daily activities. You should try and stick to your regular diet and eating patterns. The recording needs to be made for 24 hours in order to obtain an accurate result. The next day you will return to the hospital to have the tube removed and drop off the recorder.


What might the pH monitoring test reveal?

There are two main possible findings from the study:

  • Excessive acid reflux: Usually, this is diagnostic of gastro-oesophageal reflux disease (GORD). A symptoms analysis is then performed whereby your specialist will determine if the symptom episodes you recorded during the test correlated with acid reflux events. This provides more conclusive evidence that acid reflux is indeed the cause of your symptoms.

  • Normal levels of acid reflux. In this case, you do not have GORD and another explanation of your symptoms needs to be determined by your specialist.


How and where can I get 24-hour pH monitoring in Sydney?

You need to first see an oesophageal doctor for a consultation where your specialist will determine if pH monitoring is an appropriate test for you. Book an appointment to see A/Prof Santosh Sanagapalli who specialises in reflux testing and directs the lab at St Vincent's Hospital.

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