This leaflet is intended to answer some of the questions you may have about your forthcoming 24 hour oesophageal pH test. Please do not hesitate to ask if there is anything further you would like to know.

Why do I need the test?

The test measures the amount of acid that wells up (refluxes) from your stomach into your gullet (oesophagus) and will help to find out if your symptons are caused by acid reflux.

What should I expect?

	You should stop taking indigestion medication one week before the test so that we can obtain an accurate assessment of the amount of acid that is refluxing. Full instructions will be sent in your appointment letter as this can vary according to which drugs you are taking.
	You should continue taking medication for other conditions eg diabetes, epilepsy, as normal.
	You should not eat or drink anything in the four hours before the test.
	You are advised to wear a separate top and a skirt or trousers since the catheter is inserted under your top and attached to the machine which is worn on a belt around the waist.

On arrival:
The nurse will explain the procedure to you and ask you to sign a consent form. This is to ensure that you understand the test and its implications.
She will also ask you a series of questions about your symptoms and the medication you have taken for them. This will help with the interpretation of the results. Please bring a list of your medication with you.

During the test:
You will be made comfortable on the couch, sitting upright. The nurse will then pass a very fine acid-measuring catheter through your nose and into your oesophagus. You will not be put to sleep or sedated in any way since you should feel only a slight discomfort from this. The catheter will remain in place for the duration of the test (about 24 hours) and is attached to a recording machine, not much larger than a walkman, which is worn on a belt around your waist. You will be asked to complete a diary during the period of the test.

How do I complete the diary sheet?
The nurse will explain this to you at your visit. Most importantly we want you to record when you experience your symptoms eg heartburn, regurgitation etc. You do this by:

- pressing the button on the recorder every time you become aware of your symptoms (this inserts an electronic mark on to the recording) and

- by writing on the diary sheet the nature of the symptom and the time that it occurs, as displayed on the recorder.

You will also need to write down everything you eat and drink noting the start and fmish times.

Will I be able to feel the catheter?
You will be aware of the catheter in the back of your throat throughout the test but most patients find they become less aware of it with time.

Will I be able to eat and drink as normal?
We especially want you to continue with your normal diet throughout the test as we need to see what happens during a normal day. Please do not chew gum. The catheter may move very slightly as you eat and it may feel strange but we would like you to persevere as it is important to know what happens after mealtimes.

Will I be able to sleep?
On retiring you may undo the waistbelt and place the recorder, still attached to you, on your bed or bedside table. Again it is important that you sleep in your normal position and record any symptoms that disturb you during the night.

May I drive a motor vehicle?
The medical advice is that you should not drive during the test since you may be distracted. If you are coming by car please ensure that you are accompanied to each appointment by a driver.

What happens if I need to cough, vomit or blow my nose?
The catheter will be securely taped to your cheek and behind your ear and is not likely to move on these occassions. Vary rarely the catheter can be vomited back up into your mouth and in this situation you will have to remove it. To do this untape the catheter from your face, take a deep breath in and pull it out from the nose. Then place all the equipment in a plastic bag and return as arranged.

May I take any medicine for indigestion during the test?
Place do not take any indigestion medication during the test as all medications for indigestion have the effect of reducing or masking the amount of acid present and therefore will give us an inaccurate result.

Will I be able to go to work?
If possible please follow your normal daily routine. However, if you feel it inappropriate to remain at work do be as active as you normally would be at home.

Will I be able to take a bath or shower?
The recorder must not get wet so baths, showers and swimming are forbidden.

Can I damage the Equipment?
The equipment is new and expensive and we ask you to treat it with care. The catheter is particularly vulnerable and if it catches on a door handle, for example, it will be irreversibly damaged. It is therefore advisable to wear a loose top over the recorder and catheter to protect against this.

What should I do if I can not tolerate the presence of the catheter?
In this unlikely event you can remove the catheter yourself. To do this untape the catheter from your face, take a deep breath in and pull it out from the nose. After removing the catheter, place all the equipment in a plastic bag and return for your appointment as arranged. Obviously if this happens we will gain less information about your condition.

What should I expect when I return to have the catheter removed?
This appointment takes only 5-10 minutes. The recorder is stopped and the catheter is removed. Removing the catheter only takes 2-3 seconds and is not uncomfortable. The nurse will want to look at your diary sheet with you to ensure that we have all the relevant information.

When will I know the result?
The information on the recorder is downloaded onto a computer and the results printed. If there is time to do this immediately after the catheter has been removed, you may be able to view the results on screen yourself and discuss the results with the nurse. However the printout will need to be carefully analysed by the doctor and your GP will receive a copy of the final report usually within two weeks.

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