Long-term pH monitoring is used when a gastroscopy does not provide conclusive results in the diagnosis of reflux disease. pH monitoring can be performed using a catheter inserted through the nose or a probe placed in the stomach. The catheter-free method is still in its early stages, but it yields very good diagnostic results.
Here you will find further information as well as a selection of specialists and centers for long-term pH monitoring.
Up to 20 percent of all people occasionally complain of heartburn. If these symptoms occur more frequently, or if an organ-related complication is suspected, the condition is referred to as gastroesophageal reflux disease (GERD). It develops when stomach acid repeatedly flows back into the esophagus, causing irritation there.
Heartburn is the defining symptom of reflux disease. Other symptoms include
Complications of chronic reflux disease include
Reflux disease is usually diagnosed using high-resolution gastroscopy (gastric endoscopy). During this procedure, the physician examines the inside of the esophagus and stomach, looking for damage to the mucous membrane. In many patients, it is also necessary to take tissue samples from the stomach.
If the gastroscopy does not provide clear evidence, pH monitoring (NERD) can also be performed.
pH monitoring can determine whether the environment is more acidic or alkaline © drewsdesign | AdobeStock
Two different systems are available for this measurement.
The older, tried-and-true method of long-term pH monitoring requires a catheter. The physician inserts the catheter through the nose into the esophagus. It remains there for 24 hours, taking various measurements over that period.
Advantages include widespread availability and low cost.
For many patients, however, wearing the catheter is burdensome. It prevents them from going about their normal daily routine. Yet this is precisely what is needed to obtain objective results.
Alternatively, a catheter-free Bravo System® has been in use for several years. In this test, a small pH probe is secured in the lower esophagus.
It measures acid levels over two to four days and transmits the data to a decoder that the patient wears on their body. During the test period, the patient records all significant events, such as
in a log. The measurement results are then analyzed on a computer.
Most patients are unaware of this form of long-term pH monitoring. Only a few patients report a sensation of a foreign body. Serious side effects are extremely rare.
A few days after the measurement, the capsule detaches on its own from the wall of the esophagus and passes through the stomach and intestines until it is expelled.
The patient should be fasting and should have stopped taking acid-suppressing and motility-enhancing medications in a timely manner:
Exceptions may be made if you are taking these medications on a long-term basis or if the pH monitoring is planned to assess the success of treatment.
Using the analysis software provided by all manufacturers,
can be determined. These parameters are calculated for the entire measurement period as well as for the periods spent in the upright and supine positions.
In addition, an assessment can be made using specific scores, such as the Demeester score. The doctor explains the results to the patient and, if necessary, provides treatment recommendations.
Every physician listed in the Leading Medicine Guide has attained the highest level of training and certification within their respective medical specialty society. Furthermore, we contacted this physician based, among other factors, on their case volume (surgeries, treatments, and therapies), which we determined by cross-referencing various publicly available sources. Following discussions with the selected physicians and the directors of the medical facilities, as well as a subsequent internal review, they were admitted to the Leading Medicine Guide.
The quality assurance of the Leading Medicine Guide is further ensured by 8 admission criteria. Each member must meet at least 6 of them:
