What is oesophageal manometry?

This is the measurement of muscle strength within the oesophagus, which can give your doctor or nurse information about your swallowing reflex, and the strength and function of the oesophageal sphincter.

What is 24-hour pH monitoring?

This is a way of recording the amount and severity of acid reflux into the oesophagus over 24 hours.

What preparation is required?

48 hours before the test

Do not take any of the following medications:

  • Metoclopramide (Maxolon®)
  • Domperidone
  • Nitrates, calcium channel blockers, opiates, and anticholinergic drugs

If you are taking any medication not listed above and you are not sure if you should stop, please call the Louise Ryan Unit to check whether you should stop them.

Six hours before the test

Do not have anything to eat or drink. Please bring a list of your current medications with you to your appointment

How is it performed?

A nurse practitioner will perform the investigations. They will first take a history of your symptoms and health concern, and then explain the procedure in detail. You will be asked to provide written consent for this procedure. Please feel free to ask any questions or ask for further clarification from the health care professional carrying out the test.

Your nose and throat will be numbed with some nasal drops to minimize any discomfort, and a thin flexible tube will then be passed through the nose into the stomach. You will be able to breathe, swallow and talk with the tube in position. During the test, you will need to lie down on a couch and will be given 5ml of water to swallow every 30 seconds.

You may also be given food (rice or bread) if you have problems swallowing. You may have to bring your own food that causes the problem when you are swallowing if it is not rice or bread. If possible, please do not talk or swallow unless requested to do so. The pressure changes in the oesophagus are recorded on a computer, and these will be analysed and reported on afterwards.

For the 24-hour pH test, a different tube will be inserted in the same way as before. It is connected to a recorder that you will need to wear around your waist. You will be asked to press certain buttons on the recorder in order to record mealtimes, sleep periods and episodes of the symptoms you’ve been experiencing. You will also be asked to keep a written diary about your meals. It is important that you continue your normal daily activities as much as possible, for us to get a realistic picture of your acid reflux pattern.

You will need to return to the Louise Ryan Unit the next day to have the tube removed. The recorded data will then be analysed on a computer.

During the 24-hour study you will be able to follow your normal diet and daily routine.

However, we ask you to refrain from taking the following:

  • Acidic drinks, e.g., fruit juices
  • Chocolate
  • Fizzy drinks e.g., coke, lemonade
  • Chewing gum
  • Alcohol
  • Sucking sweets
  • Coffee

You may drink as much tea, milk and water as you like. You will be provided with a ‘patient diary’ to record what you have eaten and drunk. If possible, do not use more than two pillows when you go to sleep.

It will not be possible for you to have a shower during the 24-hour period. Instead, please use a flannel to wash or you can have a bath, although you must be very careful not to wet the equipment. A member of staff will provide you with further guidance.

The whole test will take approximately one hour. You will not be sedated and can therefore resume your normal activities after the test. You will be fit to drive but should not eat for 1 hour after the test.

Are there any risks/side effects?

Complications arising from these tests are very rare. They tube may be inserted into the trachea (windpipe) by mistake, but this will be immediately rectified by withdrawing it. Perforation is also a possibility, but extremely rare.

Most patients do not experience any side effects. However, some patients may find that their throat is sore for a few hours afterwards. If you suffer from sinusitis, the procedure may induce a flare-up.

Where is the test carried out?

Please arrive at the Louise Ryan Unit on the lower ground floor of the Royal Free Hospital at the date and time specified in your appointment letter. We aim to see patients on time, and therefore if you are more than 15 minutes late, we may not be able to proceed with your test.

Your referring doctor will have the results of the tests within five to 10 working days. If you do not have a follow-up appointment, please let us know.

Attendance policy

If you are unable to attend, please contact us as soon as possible on 020 7830 2923. If you fail to attend without giving advance notice, a further appointment will not be issued, and your doctor will be informed of your non-attendance.

Non-emergency hospital transport

If you need transport for medical reasons, please telephone 0333 240 4909, and you will be assessed for suitability. For more information visit our Louise Ryan unit page.