What is a 23 hour pH/impedance catheter test?

Why is this test done?

How is it done? 

The catheter is a small flexible tube with sensors. The tube goes in one nostril and is gently moved down into the esophagus. An x-ray is done to check that the tip of the tube is in the right place. 

The catheter is attached to a small recorder (monitor) that your child carries with them.  The test will record information for 23 hours. The catheter needs to stay in place for 23 hours. If the catheter comes out too soon the test needs to be repeated.  

Will this test hurt?

What needs to be done before the test?

• Your child should not eat any food or drink any liquids for 4 hours before the test. 
• The healthcare provider who ordered the test should tell you if any medicines need to be stopped before the catheter is put in. If your child is taking medicine for stomach acid it might be stopped for 7 days before the catheter is put in.  Please check with your healthcare team if you do not have this information.

What should my child be doing during the test?

• Your child should keep doing their normal activities.
• Your child should eat and drink like they usually do.  Do not give acidic drinks like apple juice, orange juice or lemonade because it can affect the study results. This is important for the test to be successful.  It is best if your child eats at least three meals before ending the study.
• It is important that your child does not pull out the catheter. We will discuss ways to keep your child from pulling the tube out.
• Your child will need to wear the recorder (monitor) while it is attached to the catheter. It can hang from the strap, clip on their clothing, or fit in some pockets.  

What do I need to do with the recorder (monitor) during the test?

• You will need to push buttons for different activities on the recorder. You will also write things in a diary.
• Some details you will write down are: 
  – kinds and amount of food or drink your child is having
  – how long they sleep 
  – how they feel or if they have symptoms
• Pressing the buttons and writing details in the diary is important.  This will help the doctor understand your child’s symptoms and how to help them best. 
• When buttons are pressed the icon will appear. The time should always be on the screen. If the time is not seen, call Children’s and ask the operator to page the GI Provider on call. 
• Do not let the recorder get wet.
• If the catheter is pulled out at home before the test is done, write that time in the diary. The test will end at that time. If the test ended too soon it will need to be repeated. Return the catheter, recorder and diary at your appointment.

How will the catheter be removed?

What do I need to do with the recorder (monitor) after the 23 hour test?

How do I find out the results?

It takes 14 days for the doctors to review the test recordings.  We will send a letter to your primary doctor and the doctor who requested the test. The doctor who ordered the test will call you with results. If you have any questions about the results, please call your doctor.

pH Impedance Diary Recording Process
MMS Ohmega pH Impedance Recorder

Each button puts a marker on the recording to show the activity.  It is important when a button is pressed your write the details about that activity in the diary. The time you press the button on the recorder should be the same time you write in the diary.  

Button	Instructions
	Lying down or sleeping Press this button when your child lays flat or they go to sleep.  Press this button again when they wake up or sit up. Write both the times and activity for the start and the end of laying down or sleeping.
	Eating or drinking Press this button when your child starts to eat or drink. Press again when they are done eating or drinking. Write both the start and stop times and what they ate or drank in the diary. Use the notes section to write what was eaten or drank. An examples is to write “toast, jelly, glass of milk”.  During the test your child should eat and drink like normal. Write everything in the log and push the buttons.
	Medicines Press this button when your child takes an oral or inhaled medicine.  Write the medicine name and what time they took it in the diary.
	Symptoms Press this button any time the main symptom(s) for being tested happens.  Examples are: chest pain, throw up, reflux, tummy pain, cough, hiccup etc.
	Write what time the symptom happened and describe it in the diary. Write how long it lasted.

• This test will run for 23 hours.  The catheter will be taken out by a GI staff member at the clinic.  
• If you have questions or concerns about the test call:
  o Between 8 am and 4pm, call 414-266-3690 to speak with the GI staff at the clinic. 
  o After 4pm, call 414-266-2000 and ask to speak to the GI (Gastroenterology) provider on call.  
• If the probe comes out early by accident or pulling, your child may need to repeat the test.  Please call the number listed above and talk to the GI staff. GI staff may tell you to go to the emergency room to replace the catheter the same day or to make a new appointment to repeat the test.
• Please do what you can to keep the tube from coming out too early.
• Bring the diary and monitor to the clinic appointment.  
• For more information, visit: www.childrenswi.org/ph
  
  
  

Your appointment to remove the catheter and turn in the pH Impedance Diary at the GI clinic (4th floor of the Craig Yabuki Tower) is: 
  
 ____________/___________/___________ at _____:_____

Study Start Time______:______      Study End Time______:______

Patient Label

PH IMPEDANCE DIARY LOG

Lying flat or sleeping (Press 2 x)

Meals/Snacks/Drinks (Press 2 x)

Medicines (Press 1 x)

Symptom Episodes (Press 1 x)

• Do not open battery compartment.
• Do not shower or let water get inside the recorder, it is not waterproof.
• Contact the GI staff, if the probe comes out or if the recorder image window does not show your child’s name and time. 

PH IMPEDANCE DIARY LOG

Patient Label:

Lying flat or sleeping (Press 2 x)

Meals/Snacks/Drinks (Press 2 x)

Medicines (Press 1 x)

Symptom Episodes (Press 1 x)

• Do not open battery compartment.
• Do not shower or let water get inside the recorder, it is not waterproof.
• Contact the GI staff, if the probe comes out or if the recorder image window does not show your child’s name and time. 

• For more information, visit: 24-hour pH-impedance probe test