What is GERD?

Esophageal Function Tests

Esophageal function tests are ambulatory investigations for assessment of GERD-induced impairment of the function of the esophagus & assessment of reflux. Esophageal function tests include

Do not undergo antireflux surgery without esophageal function test.

Esophageal manometry (Fig.3) is conducted in the out door patient clinic, you do not have to stay overnight. Following 12 hrs fasting manometry is conducted in the supine position. Via the nose a manometry catheter is passed into your stomach. Upon stepwise withdrawal of the catheter esophageal function is assessed. Furthermore, manometry is mandatory for pH probe placement. Finally manometry excludes non-GERD related functional disorders of the esophagus (i.e. achalasia).

esophageal manometry

Figure 3: esophageal manometry

Ambulatory esophageal pH monitoring (Fig. 4) assesses the presence or absence of pathologic acid reflux into the esophagus. Via the nostril, a very thin catheter containing a pH probe is introduced into the distal esophagus, the pH probe placed 5 cm above the lower esophageal sphincter (see manometry). For this test PPI treatment has to be stopped for at least 7-10 days.

ambulatory pH monitoring of the esophagus

Figure 4: ambulatory pH monitoring of the esophagus

If you can not stop PPI treatment (due to the symptoms) you will undergo combined impedance pH monitoring. During the test you indicate presence of symptoms (i.e. heartburn), body position and time of meals by pressing respective buttons on the pH recorder.

Duration of ambulatory pH monitoring: 23-24 hrs.