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Ambulatory pH & Impedance Monitoring


This outpatient test lasts 24-48 hrs and assesses the amount of esophageal acid exposure, number of reflux episodes (acidic, non acidic), correlation between reflux and symptoms and thus examines, if reflux is the cause for the patient’s complaints (heartburn, acid regurgitation, coughing, wheezing). Usually the test is started after the manometry.


The spaghetti thin catheter is introduced via the nostrils and placed within the lower end of the esophagus. The catheter is well tolerated, does not interfere with normal daily activities and is connected to a portable recorder. During the test patients mark their symptoms, eating, or changes of body position. Fusion of these data enables the physician to assess the correlation between symptoms and reflux.


The reflux monitoring report includes absolute and % times of esophageal acid exposure, number of reflux episodes and the association between symptoms and reflux. Typical findings in persons with gastroesophageal reflux disease (GERD) include abnormal esophageal acid exposure, increased number of reflux episodes and a positive correlation between symptoms and reflux events. The data of the test are used to individually tailor the treatment of GERD. A wireless catheter (Bravo pH monitor) is also available and may be used depending on patient’s preference and insurance coverage. 



Risk for complications: -                    Discomfort: +