Functional diagnostics in the MCSC: daily pH impedance monitoring


Patients with complaints of heartburn and discomfort during the passage of food often hear from the doctor the diagnosis of BBB. What is it? Gastroesophageal reflux diseaseis a chronic esophageal disease that affects about 20% of the world's population. It develops due to the regular throwing of aggressive gastric contents back into the esophagus.

How does the disease manifest itself? All the symptoms of BBB can be divided into esophageal and non-esophageal. Esophageal symptoms include:

  • heartburn;
  • belching with acid and air;
  • bitterness in the mouth;
  • feeling of full stomach;
  • violation of swallowing.

The leading esophageal symptom is heartburn. It can occur during the day or be permanent. The burning sensation spreads from the bottom to the top, increasing when the body position changes (when leaning forward, sitting, standing or lying down). Heartburn occurs on an empty stomach or after taking alcohol, carbonated drinks or fatty foods.

Such symptoms of BBB as chest pain, cough, sore throat, hoarseness of the voice belong to the non-esophageal symptoms. In such cases, before starting treatment, specialists need to prove the presence of pathological reflux and find its connection with the symptom.

The diagnosis of BBB is performed by esophageal endoscopy. If the study reveals the presence of multiple erosions or ulcers of the esophagus, then the diagnosis of BBB is not in doubt. But, in other cases, it requires clarification.

For a more reliable detection of BBB, the research method – daily pH impedance monitoring-comes to the aid of specialists. It allows you to identify all refluxes in the esophagus and the height of their spread.

The indications for daily pH impedance monitoring are:

  1. The presence of atypical symptoms of GERD.
  2. Evaluation of the effectiveness of therapy with continuing symptoms.
  3. The presence of GERD in a patient with a deliberately reduced acid production (atrophic gastritis).
  4. Suspected functional disorder of the gastrointestinal tract with ingestion of a large amount of air (aerophagia).

What training is required from the patient for daily pH impedance monitoring?  

First, the study is conducted on an empty stomach. The last meal should be no later than 6 hours before the start of the study.

Secondly, the subject stops taking drugs that reduce the acidity of the stomach. The period of time for which it is necessary to cancel the medication will tell the attending physician.   

Third, you must bring the gastroscopy result for the last 3 months with you for the study. On the basis of it, the doctor will be able to exclude contraindications to the procedure.

Technique of carrying out

Daily pH impedance monitoring is carried out for 24 hours and includes the installation of a probe, which is located in the esophagus and stomach of the patient. Before its introduction, the patient is anesthetized with a solution of lidocaine in the form of a spray. After that, the working part of the tube is inserted through the nasal passage and with the help of sips of water is pushed into the esophagus to the stomach.

After installing the probe, the skin electrode is attached to the skin of the patient's chest with patches. The Gastroscan IAM device is hung on the neck over the shoulder and the study begins. 

During the study, it is important for the patient to lead a habitual lifestyle with one period of sleep and no restrictions on food. The doctor explains how to fill out the research diary and mark various time events. This is important for assessing the association of the symptom with reflux.

During the entire study, the patient remains in the department, under the supervision of the medical staff of our center. Therefore, we suggest giving preference to a comfortable form of clothing – a T-shirt, sports pants, comfortable shoes. Men who have excessive hair on the chest should shave off a small area of skin on the upper half of the chest in front in advance.

Please note that during the procedure, the probe is attached to the skin with a patch. If you have noticed an allergy, we recommend that you take a hypoallergenic patch with you.

The transcription of the graphs is carried out on the next day after the completion of the study.  The results with the doctor's interpretation are prepared within two days. You can pick them up in person or receive them by email.

You can make an appointment for a consultation with a specialist and the procedure through the contract department or Call Center.

GBUZ Moscow Clinical Scientific Center named after Loginov MHD