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The esophagus is the food pipe that carries the food and liquid we consume into the stomach. When you swallow, a strong muscular ring around the bottom of your esophagus known as lower esophageal sphincter (LES) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again till next food/liquid intake (Antireflux Mechanism). If the sphincter fails to function normally or weakens, stomach acid can flow back up into your esophagus. The stomach lining is thick enough to bear the action of its acid and juices. The same is not tolerated by the esophageal lining. Hence the constant backwash (acid reflux) of acid irritates the lining of your esophagus, often causing it to become inflamed and producing symptoms of heartburn and acid regurgitation.
pH is a measure of acidity or alkalinity. 24 hour esophageal pH and impedance monitoring detects this acid reflux and measures the amount of acid in your lower esophagus while you do your day to day activities for 24 hour period.


  • Symptoms of GERD originating from esophagus such as chest pain, heartburn, and/or difficulty swallowing, associated chronic cough.
  • An x-ray (barium swallow or upper GI series) or endoscopy may show abnormalities that need further evaluation.
  • It is often done before and after medical or surgical treatment of acid reflux to evaluate response of treatment.

8AM – 7PM
8AM – 5PM
8AM – 5PM


  • You will be asked not to eat or drink anything eight hours before your manometry as an empty stomach allows for the best and safest procedure.
  • You will have to tell all details pertaining to your medical history, allergies and medications. Certain medications, which affect the function of esophagus like metoclopramide, beta blockers, erythromycin, antacids H2 blockers and proton pump inhibitors etc. need to be stopped few days before endoscopy as they can interrupt with the test results. They usually need to be discontinued at least 3-4 days beforehand.


  • You will be asked to lie down on your back. Local anesthetic gel will be applied into your nostrils. In some situations, it may be required to pass the tube through your mouth or using endoscopy.
  • A thin flexible lubricated tube is passed through your nose and advanced into your stomach while you swallow sips of water. Mild, brief gagging may occur while the tube is passed.
  • The tube will then be pulled back into your esophagus and taped to your cheek.
  • One end of the tube is in your esophagus, which measures when and how much stomach acid comes up your esophagus. The other end of the tube is attached to a portable recorder that is carried at your waist.
  • You will be sent back to your regular daily activities.
  • The acidity in the lower esophagus is recorded on a paper tape over 12 to 24 hours. You will be instructed to press the respective buttons on the recorder as per your meal time, sleep time etc.. When you experience a reflux or other symptoms, you should press a button on the recorder. This marks the time so as to see how it relates to the acidity levels measured by the probe.
  • After the prescribed duration of recording, you will be asked to come back to your doctor. Your doctor analyzes the results. Your doctor will be able to see how your symptoms, certain foods, and certain times of day relate to one another.


Precautions are taken to prevent any complication. Generally, the tube it is easily tolerated, once inserted.


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Antrang was started as ‘Antrang Endoscopy Center’ at Kolhapur by Dr. Vivekanand Kulkarni – A pioneer in the field of Gastrointestinal (G.I.) Endoscopy in Maharashtra and North Karnataka. Antrang has been providing Advanced quality medical services in Digestive diseases since 35 years. Antrang Endoscopy Center is a Brand name in Gastrointestinal Endoscopy since 1985 and now it has developed into Antrang Hospital-a Comprehensive under one roof Superspeciality Hospital with more focus on Digestive diseases.

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