Different pH tests are used to determine if there is reflux of stomach acid and contents into the food pile (a condition known as gastroesophageal reflux).
Doctors at Riley at IU Health perform two types of pH tests:
- Impedance probe study. An impedance probe study is used to detect both acid and non-acid reflux. Similar to a pH probe test, a small plastic tube is passed through the nose and into the esophagus. Sensors at the end of the tube are placed at specific spots along the esophagus. This only takes a few minutes without sedation. If your child's doctor orders an upper endoscopy, the impedance probe can be placed during that procedure while your child is under sedation. The impedance probe remains in place for 24 to 26 hours. Your child wears a small external device to record signals sent by the probe at each occurrence of acid and non-acid reflux.
- Bravo probe. A Bravo probe test is similar to a pH probe test except it uses a small capsule instead of a long tube. The capsule is passed through the nose and is attached to the esophagus where it remains in place for 48 hours. Using wireless technology, the capsule sends data about acid reflux to a small recorder worn by your child. A Bravo probe test is always performed under sedation in the endoscopy suite at Riley at IU Health in conjunction with an upper endoscopy. The capsule naturally detaches from the esophagus wall and passes out through the stool within two weeks. The Bravo test is generally not used with children younger than 4 years old because the capsule may get stuck in the gastrointestinal tract. The Bravo probe provides two advantages over the pH probe: There is no tube sticking out of your child's nose, and your child does not feel the presence of the capsule.
What to Expect
What to Expect
You can expect the following during an impedance probe study:
- If your child is having an impedance probe placed in the doctor's office, you will be given instructions on when and where to check in to for the probe placement. Your child will not be allowed to have any food or drink for four hours prior to probe placement. Once you arrive, a gastrointestinal nurse will provide an explanation of the procedure and answer any questions. A thin flexible probe will be inserted into your child’s nostril and connected to a data logger. It will only take a few minutes to pass the probe; your child will not be sedated for it. A chest X-ray will be taken after the probe is placed to verify correct placement. You will then be released to go home or to your hotel. You will be given the pager number of the nurse who will be on call while the study is being done. You will be given instructions as to what time to return the next day to have the probe removed. The probe remains in place for 24 to 26 hours, and your child can eat and drink normally during that time. The nurse will give you more information on feeds if needed.
- If your child is having an impedance probe placed during an upper endoscopy, a thin flexible probe will be inserted into your child’s nostril at the conclusion of the procedure, before he or she is awoken from anesthesia. The probe will be connected to a data logger. A chest X-ray will be taken while your child is in the recovery room to verify correct placement. A gastrointestinal nurse or technician will explain the procedure and answer questions prior to the procedure. You will be given the pager number of the nurse who is on call during the time that the probe is in place. You will be given instructions as to what time to return the next day to have the probe removed. The tube remains in place for 24 to 26 hours, and your child can eat and drink normally during that time. The nurse will give you more information on feeds if needed.
You can expect the following during a Bravo probe:
- A Bravo study is always done in conjunction with an upper endoscopy, which is done under sedation or anesthesia. A small capsule will be attached to the esophagus during the upper endoscopy procedure. The gastroenterologist will be able to determine the correct capsule placement in the esophagus during the procedure. A very small amount of tissue is suctioned into the capsule, which allows it to attach to the esophagus. A gastrointestinal nurse or technician will give you detailed instructions on how to record data during the 48-hour study and when to return the data logger. The capsule falls off the esophagus in a few days and leaves the body through the stool. If you do not see the capsule in your child’s stool after two weeks, call the doctor. Your child's doctor may use a chest X-ray to confirm that the capsule detached from the esophagus.
Locations
Locations
Locations
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.