Effect of Ambulatory 24-Hour Esophageal pH Monitoring on Reflux-Provoking Activities

Ambulatory 24-hr esophageal pH monitoring isconsidered the gold standard for diagnosinggastroesophageal reflux disease (GERD). The currentapproach is to encourage patients to pursue theireveryday activity in order to obtain near-physiologicalrecordings. However, the effect of the test itself onreflux-provoking activities has never been evaluated.Thus, the aim of our study was to assess daily foodconsumption, habits, symptoms, sleep, and perceivedexperience of patients undergoing pH testing as comparedto an off test (normal) day. Patients reported type andtime spent in each activity pursued, food ingested and length of each meal, habits, frequency andseverity of GERD and other related symptoms, sleepdisturbances, side effects, and overall perceivedexperience during pH testing and four weeks later,during a normal day. Fifty-four patients enrolled. pHtesting significantly reduced time spent being active,number of meals and cups of coffee consumed, andfrequency of GERD symptoms. Almost half of the patients reported having dysphagia during the test. Mostpatients experienced side effects and stated that thetest bothered them most of the time. In conclusion, pHtesting has a significant effect on decreasing reflux-provoking activities — patientstend to assume a more sedentary lifestyle. This mayinfluence the reliability of the test as a physiologicmeasure of acid reflux.